This nationwide retrospective cohort study enrolled patients from the Taiwan National Health Insurance Research Database (NHIRD), which contains health-care information for more than 23 million (> 99%) residents of Taiwan [14 ]. From a cohort of 2,826,059 patients with T2D—diagnosed using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 250 (between 2010 and 2015) or International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes E11 and E13 (between 2016 and 2019)—we identified 43,568 patients who had undergone PAD revascularization. Of the identified patients, 17,975 had been treated with SGLT2i (n = 3,389) or DPP4i (n = 15,726). After excluding patients who had used these study agents before the index date of PAD revascularization, we identified a total of 2,455 and 8,695 patients who had received first prescriptions for SGLT2i (empagliflozin, dapagliflozin, or canagliflozin) and DPP4i (saxagliptin, vildagliptin, sitagliptin, linagliptin, or alogliptin) during the study period, respectively. Notably, according to Taiwan’s National Health Insurance regulations, patients with T2D cannot use SGLT2i and DPP4i simultaneously. The index date for each study group was defined as the date of the first prescription for SGLT2i or DPP4i after PAD revascularization. The follow-up period was defined as the time from the index date to the independent occurrence of any study outcome, discontinuation of the index drug, or the end of the study period (December 31, 2020), whichever occurred first. The patient enrollment flowchart is illustrated in Fig. 1. The Institutional Review Board of Chang Gung Medical Foundation approved this study (201801427B0). Informed consent was waived because the original identification number of each patient in the NHIRD had been encrypted and deidentified to protect their privacy.

Enrollment of patients with T2D who were treated with SGLT2i or DPP4i after PAD revascularization. DPP4i dipeptidyl peptidase-4 inhibitors, PAD peripheral artery disease, SGLT2i sodium–glucose cotransporter-2 inhibitors, T2D type 2 diabetes

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