SGLT2 Inhibitor Therapy Reduces Mortality, Hospitalizations Across HF Subgroups

Sodium-glucose cotransporter 2 (SGLT2) inhibitor use is associated with a significant reduction in all-cause and cardiovascular mortality in patients with heart failure (HF), according to research presented at the American College of Cardiology (ACC) 2021 Annual Meeting, held May 15 to 17, 2021.

Although SGLT2 inhibitors are known to reduce the risk of HF hospitalization and cardiovascular mortality among people with HF, the efficacy of SGLT2 inhibitors in terms of secondary clinical trial endpoints or HF patient subgroups is not known.

Researchers conducted a systematic review and meta-analysis of randomized controlled trials focused on SGLT2 inhibitor therapy in patients with HF. In particular, the researchers were interested in mortality, hospitalizations, and subgroup analyses of age, sex, renal function, HF class, and ejection fraction.

The review included 9 studies with 19,091 patients, 52.5% of whom received SGLT2 inhibitor therapy. The mean follow-up ranged from 3 months to 4.2 years. All-cause mortality, cardiovascular mortality, and HF hospitalizations were significantly lower in patients treated with SGLT2 inhibitors vs placebo (hazard ratio [HR], 0.85, 0.87, and 0.77, respectively).

A composite measure of cardiovascular mortality, HF hospitalizations, or urgent HF-associated visits was also significantly reduced with SGLT2 inhibitor therapy in subgroups of patients who were men, women, aged younger than 65 years, aged 65 years and older, had an estimated glomerular filtration rate (eGFR) of less than 60, had an eGFR of 60 and higher, New York Heart Association (NYHA) class II, NYHA class III and higher, and HF with preserved ejection fraction (HR, 0.77; 95% CI, 0.62-0.97).

“SGLT2 [inhibitors] significantly reduce all-cause and [cardiovascular mortality] among patients with HF,” the researchers concluded. “Moreover, [cardiovascular mortality] or hospitalizations [and] urgent visits for HF are consistently lowered by SGLT2 [inhibitors] across subgroups of sex, age, renal function, functional class, and [ejection fraction].”

Reference

Cardoso R, Graffunder FP, Ternes CMP, Fernandes G, Rocha AV, Bhatt D. SGLT2 inhibitors decrease cardiovascular mortality or heart failure hospitalizations in heart failure subgroups: a systematic review and meta-analysis. Presented at: American College of Cardiology 2021 Annual Meeting; May 15-17, 2021.