{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:55:35Z","timestamp":1789390535206,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,8,16]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The sodium\u2010glucose cotransporter 2 inhibitor canagliflozin reduced the risk of first cardiovascular composite events in the CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) trial. In this post hoc analysis, we evaluated the effect of canagliflozin on total (first and recurrent) cardiovascular events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The CREDENCE trial compared canagliflozin or matching placebo in 4401 patients with type 2 diabetes, albuminuria, and estimated glomerular filtration rate of 30 to &lt;90\u2009mL\/min per 1.73\u00a0m\n              <jats:sup>2<\/jats:sup>\n              , over a median of 2.6\u2009years. The primary outcome was analyzed as a composite of any cardiovascular event including myocardial infarction, stroke, hospitalization for heart failure, hospitalization for unstable angina, and cardiovascular death. Negative binomial regression models were used to assess the effect of canagliflozin on the net burden of cardiovascular events. During the trial, 634 patients had 883 cardiovascular events, of whom 472 (74%) had just 1 cardiovascular event and 162 (26%) had multiple cardiovascular events. Canagliflozin reduced first cardiovascular events by 26% (hazard ratio, 0.74 [95% CI, 0.63\u20130.86];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and total cardiovascular events by 29% (incidence rate ratio, 0.71 [95% CI, 0.59\u20130.86];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). The absolute risk difference per 1000 patients treated over 2.5\u2009years was \u221244 (95% CI, \u221267 to \u221221) first cardiovascular events and \u221273 (95% CI, \u2212114 to \u221233) total events.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Canagliflozin reduced cardiovascular events, with a larger absolute benefit for total cardiovascular than first cardiovascular events. These findings provide further support for the benefit of continuing canagliflozin therapy after an initial event to prevent recurrent cardiovascular events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration Information<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique Identifier: NCT02065791.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.025045","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T09:16:25Z","timestamp":1659690985000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of Canagliflozin on Total Cardiovascular Burden in Patients With\u00a0Diabetes and Chronic Kidney Disease:\u00a0A\u00a0Post Hoc Analysis From the CREDENCE Trial"],"prefix":"10.1161","volume":"11","author":[{"given":"Jing\u2010Wei","family":"Li","sequence":"first","affiliation":[{"name":"The George Institute for Global Health UNSW Sydney Sydney Australia"},{"name":"Department of Cardiology, Xinqiao Hospital Army Military Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9370-9913","authenticated-orcid":false,"given":"Clare","family":"Arnott","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health UNSW Sydney Sydney Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital Sydney Australia"},{"name":"Sydney Medical School The University of Sydney Sydney New South Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-3730","authenticated-orcid":false,"given":"Hiddo J. 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