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To mitigate protopathic or ascertainment bias, patients with MACEs prior to the study period were excluded, and repeat PSM was performed

In this multicenter study of over 250,000 hospitalizations, use of novel diabetes medications prior to discharge was rare, raising the concern for systematic underutilization after discharge, Michael Fralick, PhD, MD, MSc, assistant professor in the department of medicine at University of Toronto and clinical scientist at Sinai Health in Toronto, and colleagues wrote

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A plausible explanation of this apparent dichotomy is that p53 promotes cell survival by preventing excessive increases in ROS under moderate oxidative stress, whereas when the oxygen species increase over a threshold level, it switches to becoming a ROS inducer, triggering cell death