Content of review 1, reviewed on February 16, 2021

The impact of the CREDENCE trial on the cardiovascular community is undisputed and post-hoc analyses of this trial are certainly of importance.

The research groups present subgroup analyses of the CREDENCE trial showing consistency of the primary outcome across a number of subgroups.

The data are well presented and the manuscript is presented straight forward.

Some aspects merit comment:

1) The subgroup of different baseline eGFR values is already presented in the NEJM main publication and should not be presented as novel data (currently the abstract suggests novelty). Same with UACR.

2) Were subgroups pre-specified in the study protocol. The NEJM publication mentions pre-specified subgroups (Figure 2 of the main publication). Please comment.

3) Outcome was neutral in the groups with AFib and NHYA III with the caveat of limited sample size. This is extremely important as cardiologists start to prescribe prevalent heart failure patients SGLT-2 inhibitors more and more. The limited data on symptomatic heart failure patients, many of whom are in AFib, should be mentioned.

4) Are NT-proBNP/BNP levels available in the chort.

5) Specify “history of CVD“. There is a discrepancy between the groups “history of CVD”, “Heart failure”, “Atrial Fibrillation”.

Source

    © 2021 the Reviewer.

References

    Clare, A., Jing-Wei, L., P., C. C., Dick, d. Z., L., N. B., L., H. H. J., M., C. D., Anubha, A., D., H. M., A., F. G., George, B., I-Hsin, C. T., Kent, F., Norman, R., Bernard, Z., J., J. M., Vlado, P., Bruce, N., W., M. K. 2021. The effects of canagliflozin on heart failure and cardiovascular death by baseline participant characteristics: Analysis of the CREDENCE trial. Diabetes, Obesity and Metabolism.