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Finerenone exposure and ischaemic stroke in patients with type 2 diabetes and chronic kidney disease: A propensity
Wu-Lung Chuang1, Ruey-Hwang Chou2, Yuan-Hung Wang3
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Lukang Christian Hospital, Changhua 505, Taiwan.
Background:
Type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) commonly coexist and are associated with an increased risk of ischaemic stroke. Finerenone has demonstrated benefits on composite renal and cardiovascular outcomes in randomised trials; however, ischaemic stroke has generally been evaluated as part of composite endpoints, and real-world evidence focusing on this outcome remains limited.
Methods:
We conducted a retrospective cohort study using the TriNetX Global Research Network to evaluate the association between finerenone use and incident ischaemic stroke among adults with newly diagnosed T2DM who subsequently developed CKD. Finerenone users were compared with non-users. Propensity score matching was applied to balance demographic characteristics and baseline comorbidities. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).
Results:
A total of 125,086 eligible patients were identified before matching, including 1,990 finerenone users. After 1:1 propensity score matching, 1,990 finerenone users were matched with 1,990 non-users with adequate covariate balance. Finerenone use was associated with a lower observed hazard of ischaemic stroke both before matching (adjusted HR, 0.30; 95% CI, 0.24-0.36) and after matching (adjusted HR, 0.33; 95% CI, 0.26-0.42).
Conclusions:
In this real-world cohort of patients with T2DM and CKD, finerenone use was associated with a lower observed hazard of ischaemic stroke.
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