Heart failure & cardiomyopathies
SGLT-2 inhibitors and mortality among patients with heart failure with reduced ejection fraction: linked database study
Authors' conclusion
In this large database study among patients with heart failure with reduced ejection fraction, SGLT-2 inhibitor use was associated with a 25% lower risk of all cause mortality, supporting their effectiveness in routine clinical practice.
Study context
- Population
- Patients with HF, aged ≥45 years, LVEF ≤40%; national registers in Denmark, July 2020 to June 2023
- Participants
- 6,776 vs 14,686
- Exposure
- SGLT-2 inhibitor initiation vs continued other standard-of-care HF drugs without SGLT-2 inhibitors
- SGLT-2 inhibitor usersn = 6,776
- Non-usersn = 14,686reference
- Outcome
- All cause mortality
Methodological detailsinverse probability of treatment weighting based on propensity scores, national registers
- Inverse probability of treatment weighting based on propensity scores
- National registers
Main finding
As reported in the abstract
| Group | Value | Incidence rate |
|---|---|---|
| SGLT-2 inhibitor users | 374 events | 5.8 per 100 person years |
| Non-users | 1602 events | 8.5 per 100 person years |
Value
SGLT-2 inhibitor users374 events
Non-users1602 events
Incidence rate
SGLT-2 inhibitor users5.8 per 100 person years
Non-users8.5 per 100 person years
- Weighted HR, SGLT-2 inhibitor users vs non-users
- 0.75 (0.66 to 0.85) (95% CI)
- Weighted incidence rate difference per 100 person years, SGLT-2 inhibitor users vs non-users
- −1.6 (−2.5 to −0.8) (95% CI)
Observational data: associations, not effects.
Secondary outcomes
CV mortality or HF hospital admission; CV mortality; HF hospital admission
- Weighted HR, CV mortality or HF hospital admission, SGLT-2 inhibitor users vs non-users
- 0.94 (0.85 to 1.04) (95% CI)
- Weighted HR, CV mortality, SGLT-2 inhibitor users vs non-users
- 0.77 (0.64 to 0.92) (95% CI)
- Weighted HR, HF hospital admission, SGLT-2 inhibitor users vs non-users
- 1.03 (0.92 to 1.15) (95% CI)
All cause mortality, by diabetes (subgroup)
- Weighted HR with diabetes
- 0.73 (0.58 to 0.91) (95% CI)
- Weighted HR without diabetes
- 0.73 (0.63 to 0.85) (95% CI)
- Interaction P=0.99
Original publication
SGLT-2 inhibitors and mortality among patients with heart failure with reduced ejection fraction: linked database study. BMJ. Published 6 November 2024. doi:10.
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