{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:36:32Z","timestamp":1781195792866,"version":"3.54.1"},"reference-count":27,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,6,19]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 2 diabetes (T2D) and chronic kidney disease (CKD) significantly increase the risk of cardiovascular events, including death and heart failure (HF). The FLOW trial demonstrated that semaglutide reduces all-cause death, cardiovascular events and HF risk in patients with T2D and CKD. Since there is a difference in patient characteristics between clinical trials and real-world data, this study aims to investigate the association of semaglutide and all-cause death, acute HF or cardiovascular outcomes in patients with T2D and CKD using the data platform.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre retrospective observational study using TriNetX, a global healthcare data platform. We identified 1 151 750 patients aged \u226518 years with T2D and CKD diagnosed before 31 December 2020. Among these, 14\u2009511 patients initiated semaglutide and 69\u2009700 initiated sitagliptin between 1 January 2018 and 31 December 2020. After propensity score matching, 13\u2009703 patients were included in each group. The primary outcome was the 3-year incidence of all-cause death. Secondary outcomes included acute HF, acute myocardial infarction and stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 3-year risk of all-cause death in the semaglutide group relative to the sitagliptin group was significantly lower (7.2% (943\/13 703) vs 9.5% (1196\/13 703); p&lt;0.001; HR, 0.76; 95% CI, 0.70 to 0.83). Similarly, the semaglutide group was less likely to have acute HF (12.1% vs 13.1%; HR, 0.92; 95%\u2009CI, 0.86 to 0.98). However, the risks of acute myocardial infarction and stroke in the semaglutide group relative to the sitagliptin group were not significant (9.6% vs 9.5%; HR, 1.01; 95%\u2009CI, 0.93 to 1.09 in acute myocardial infarction, and 9.2% vs 9.0%; HR, 1.02; 95%\u2009CI, 0.94 to 1.10 in stroke).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with T2D and CKD, semaglutide was associated with a lower 3-year risk of all-cause death compared with sitagliptin.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003382","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T02:57:01Z","timestamp":1752548221000},"page":"e003382","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of semaglutide on survival outcomes in patients with type 2 diabetes and chronic kidney disease"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9639-5470","authenticated-orcid":false,"given":"Takefumi","family":"Kishimori","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8213-7999","authenticated-orcid":false,"given":"Takao","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine Faculty of Medicine, Kyoto, Japan"},{"name":"Department of clinical trial facilitation, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuyuki","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Tani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Yamaji","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jumpei","family":"Koike","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omi Medical Center, Kusatsu, 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and Cardiovascular-Related Mortality in CKD Patients With and Without Heart Failure: A Population-Based Cohort Study in Kaiser Permanente Southern California","volume":"5","author":"Yu","year":"2023","journal-title":"Kidney Med"},{"key":"2026010701103390000_12.2.e003382.9","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1111\/dom.14074","article-title":"Heart failure and chronic kidney disease manifestation and mortality risk associations in type 2 diabetes: A large multinational cohort study","volume":"22","author":"Birkeland","year":"2020","journal-title":"Diabetes Obes Metab"},{"key":"2026010701103390000_12.2.e003382.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2403347"},{"key":"2026010701103390000_12.2.e003382.11","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1016\/j.jacc.2024.08.004","article-title":"Effects of Semaglutide on Heart Failure Outcomes in Diabetes and Chronic Kidney Disease in the FLOW 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