{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:49Z","timestamp":1792471129145,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP22H03554"],"award-info":[{"award-number":["JP22H03554"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23K11931"],"award-info":[{"award-number":["JP23K11931"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP24K21306"],"award-info":[{"award-number":["JP24K21306"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002241","name":"Japan Science and Technology Agency","doi-asserted-by":"publisher","award":["JPMJFR205J"],"award-info":[{"award-number":["JPMJFR205J"]}],"id":[{"id":"10.13039\/501100002241","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine adjusted cardiovascular outcome associations among older adults with type 2 diabetes who had sustained sodium\u2013glucose cotransporter 2 inhibitor (SGLT2i) or dipeptidyl peptidase\u20104 inhibitor (DPP\u20104i) therapy for \u2265\u20096\u2009months, focusing on the maintenance phase and heterogeneity across body mass index (BMI) strata.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide\u2010scale landmark cohort study using linked claims and health examination data in Japan. Adults aged \u2265\u200965\u2009years with type 2 diabetes who maintained SGLT2i or DPP\u20104i for \u2265\u20096\u2009months were included. Weighted discrete\u2010time hazard models with inverse probability of treatment and censoring weighting were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 24\u2009380 participants (4223 SGLT2i; 20\u2009157 DPP\u20104i), sustained SGLT2i use was associated with lower hazards of heart failure hospitalisation (HR, 0.775; 95% CI, 0.628\u20130.958) and MACE (myocardial infarction, stroke or all\u2010cause mortality) (HR, 0.848; 95% CI, 0.753\u20130.955). Stroke hazard was lower (HR, 0.834; 95% CI, 0.721\u20130.965), whereas myocardial infarction and all\u2010cause mortality were not clearly different. The association for heart failure hospitalisation was directionally consistent across BMI strata (\n                      <jats:italic>p<\/jats:italic>\n                      for interaction\u2009=\u20090.953), whereas MACE estimates differed across BMI strata (\n                      <jats:italic>p<\/jats:italic>\n                      for interaction\u2009=\u20090.007), with no clear association in the lowest BMI group (&lt;\u200922\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; HR, 1.226; 95% CI, 0.931\u20131.615).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among older adults who had maintained treatment for \u2265\u20096\u2009months, sustained SGLT2i use was associated with lower subsequent risks of heart failure hospitalisation and MACE. Heart failure associations were directionally consistent across BMI strata, whereas BMI\u2010related MACE heterogeneity was exploratory and should not be interpreted as evidence to guide treatment by BMI alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71151","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:54:24Z","timestamp":1785290064000},"page":"9385-9394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sustained Use of\n                    <scp>SGLT2<\/scp>\n                    Inhibitors and Cardiovascular Outcomes in Older Adults: A Landmark Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2520-9949","authenticated-orcid":false,"given":"Hisashi","family":"Noma","sequence":"first","affiliation":[{"name":"Department of Interdisciplinary Statistical Mathematics The Institute of Statistical Mathematics  Tokyo Japan"},{"name":"The Graduate Institute for Advanced Studies The Graduate University for Advanced Studies (SOKENDAI)  Tokyo Japan"},{"name":"Advanced Medicine, Innovation and Clinical Research Center Tottori University Hospital  Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Sunada","sequence":"additional","affiliation":[{"name":"Advanced Medicine, Innovation and Clinical Research Center Tottori University Hospital  Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Futoshi","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management Kyushu University Graduate School of Medical Sciences  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megumi","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management Kyushu University Graduate School of Medical Sciences  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhisa","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management Kyushu University Graduate School of Medical Sciences  Fukuoka 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