Use of SGLT2 Inhibitors Reduces Heart Failure and Hospitalization: A Multicenter, Real-World Evidence Study

Abstract

Background New research has produced evidence to support the use of diabetic drugs to prevent heart failure (HF). However, evidence of their effect in real-world clinical practice is limited. Objective The objective of this study is to establish whether real-world evidence supports clinical trial findings that use of sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces rate of hospitalization and incidence of HF for patients with cardiovascular disease and type 2 diabetes. Methods This retrospective study used electronic medical records to compare rate of hospitalization and incidence of HF among 37,231 patients with cardiovascular disease and type 2 diabetes under treatment with SGLT2i, glucagon-like peptide-1 receptor agonist (GLP1-RA), both, or neither. Results Significant differences were found between medication class prescribed and number of hospitalizations (p < 0.0001) and incidence of HF (p < 0.0001). Post-hoc tests revealed reduced incidence of HF in the group treated with SGLT2i relative to GLP1-RA alone (p = 0.004) or neither of these key drugs (p < 0.001). No significant differences were observed between the group receiving both drug classes compared to SGLT2i alone. Discussion Results of this real-world analysis are consistent with clinical trial findings that SGLT2i therapy reduces incidence of HF. The findings also suggest the need for further points of research in demographic and socioeconomic status differences. Conclusion Real-world evidence supports clinical trial findings of SGLT2i reducing both incidence of HF and rate of hospitalization.

Keywords: Cardiovascular Diseases; Diabetes; Heart Failure; Multimorbidity; Quality Of Health Care; Therapeutics.

Figure 1:

Age distribution by treatment group, demarcated by being either < 65 years old or ≥ 65 years old. GLP1-RA = glucagon-like peptide-1 receptor agonists; SGLT2i = sodium-glucose cotransporter-2 inhibitors.

Figure 2:

Percentage of patients with 1 all-cause hospitalization after starting treatment. GLP1-RA = glucagon-like peptide-1 receptor agonists; SGLT2i = sodium-glucose cotransporter-2 inhibitors.

Figure 3:

Percentge of patients with 1 heart failure after starting treatment. GLP1-RA = glucagon-like peptide-1 receptor agonists; SGLT2i = sodium-glucose cotransporter-2 inhibitors.