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Use of sodium-glucose co-transporter 2 inhibitors in patients with heart failure and type 2 diabetes mellitus: data from the Swedish Heart Failure Registry.

Becher, PM; Schrage, B; Ferrannini, G; Benson, L; Butler, J; Carrero, JJ; Cosentino, F; Dahlström, U; Mellbin, L; Rosano, GMC; et al. Becher, PM; Schrage, B; Ferrannini, G; Benson, L; Butler, J; Carrero, JJ; Cosentino, F; Dahlström, U; Mellbin, L; Rosano, GMC; Sinagra, G; Stolfo, D; Lund, LH; Savarese, G (2021) Use of sodium-glucose co-transporter 2 inhibitors in patients with heart failure and type 2 diabetes mellitus: data from the Swedish Heart Failure Registry. Eur J Heart Fail, 23 (6). pp. 1012-1022. ISSN 1879-0844 https://doi.org/10.1002/ejhf.2131
SGUL Authors: Rosano, Giuseppe Massimo Claudio

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Abstract

AIMS: Use of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in real-world heart failure (HF) is poorly characterised. In contemporary patients with HF and type 2 diabetes mellitus (T2DM) we assessed over time SGLT2i use, clinical characteristics and outcomes associated with SGLT2i use. METHODS AND RESULTS: Type 2 diabetes patients enrolled in the Swedish HF Registry between 2016-2018 were considered. We performed multivariable logistic regression models to assess the independent predictors of SGLT2i use and Cox regression models in a 1:3 propensity score-matched cohort and relevant subgroups to investigate the association between SGLT2i use and outcomes. Of 6805 eligible HF patients with T2DM, 376 (5.5%) received SGLT2i, whose use increased over time with 12% of patients on treatment at the end of 2018. Independent predictors of SGLT2i use were younger age, HF specialty care, ischaemic heart disease, preserved kidney function, and absence of anaemia. Over a median follow-up of 256 days, SGLT2i use was associated with a 30% lower risk of cardiovascular (CV) death/first HF hospitalisation (hazard ratio 0.70, 95% confidence interval 0.52-0.95), which was consistent regardless of ejection fraction, background metformin treatment and kidney function. SGLT2i use was also associated with a lower risk of all-cause and CV death, HF and CV hospitalisation, and CV death/myocardial infarction/stroke. CONCLUSION: In a contemporary HF cohort with T2DM, SGLT2i use increased over time, was more common with specialist care, younger age, ischaemic heart disease, and preserved renal function, and was associated with lower mortality and morbidity.

Item Type: Article
Additional Information: © 2021 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: HFmrEF, HFpEF, Heart failure, Outcomes, SGLT2 inhibitors, SwedeHF, 1102 Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Eur J Heart Fail
ISSN: 1879-0844
Language: eng
Dates:
DateEvent
16 July 2021Published
2 March 2021Published Online
15 February 2021Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 33599357
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113286
Publisher's version: https://doi.org/10.1002/ejhf.2131

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