Uptake of novel evidence-based therapies in patients with type 2 diabetes after a cardiovascular event: insights from CANHEART
Bibliographic record
Abstract
Background: A cardiovascular (CV) hospitalization is a seminal opportunity to implement guideline-directed medical therapy (GDMT). Sodium-glucose transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1RAs) can improve outcomes among those with type 2 diabetes mellitus (T2DM) and CV disease. Methods: We conducted a population-based cohort study among patients aged ≥ 66 years with T2DM in Ontario hospitalized for a CV event (myocardial infarction, heart failure, peripheral arterial disease, ischemic stroke) from June 2015 to March 2022, who were followed until March 2023. We examined use of GDMT before vs after the index event, including use of SGLT2is, GLP1RAs, statins, and others medications. Results: We identified 75,869 people aged ≥ 66 years with T2DM (median age 78 years; 43% female). The proportion receiving SGLT2is was 9% before index hospitalization and 29% during the follow-up period. GLP1RA was used for 1% before vs 9% after, compared with 65% before and 86% after for statins. Use of novel GDMT increased across the follow-up period. The incidence of SGLT2i use 1-year posthospitalization was 4% in 2016 vs 39% in 2021; for GLP1RA use, the incidence was 0% in 2016 vs 11% in 2021. Conclusions: A rise in the use of novel GDMT suggests increasing adoption of therapies to optimize secondary prevention in patients with T2DM and CV disease after index CV events.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".