By Colin Kenny, Editor – Diabetes Distilled
A retrospective observational study of new sodium glucose co-transporter 2 (SGLT-2) inhibitor users investigated whether the heart failure (HF) protective effect of these drugs differed depending on the presence or absence of cardiovascular disease (CVD) and prescription period, and compared them to dipeptidyl peptidase-4 inhibitors. SGLT-2 inhibitors reduced hospitalisation for HF compared with dipeptidyl peptidase-4 inhibitors. This protective effect was apparent after 30 days in patients with established CVD, but appeared later in patients without CVD.
HF is a major comorbidity in patients with type 2 diabetes. Outcome studies have suggested that the protective effect of SGLT-2 inhibitors on HF is a class effect. Data on 1,044,194 new DPP-4 inhibitor users and 59,480 new SGLT-2 inhibitor users were obtained from health records kept by a Korean health insurance group. In total, 59,479 pairs were matched.
There were 1,025 hospitalisations for HF among the matched patients. Among the patients with underlying CVD, patients treated with SGLT-2 inhibitors had a lower risk of hospitalisation for HF at all time points compared with patients given DPP-4 inhibitors. However, the use of SGLT-2 inhibitors in patients without underlying CVD only showed a significantly lower risk 3 years after drug initiation. This suggests that SGLT-2 inhibitors protect against hospitalisation for HF in patients with existing CVD rather than immediately ameliorating the risk of CVD.
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