Heart failure & cardiomyopathies

SGLT2 Inhibitor Use and Risk of Clinical Events in Patients With Cancer Therapy–Related Cardiac Dysfunction

JACC Heart FailPublished Retrospective cohort study

Authors' conclusion

SGLT2 inhibitor use is associated with improved outcomes in patients with CTRCD/HF.

Study context

Population
Adults with T2DM and cancer exposed to potentially cardiotoxic antineoplastic therapy, with subsequent cardiomyopathy or heart failure (HF) (cancer therapy-related cardiac dysfunction (CTRCD)/HF), 2013–2020; ischemic heart disease excludedmatched cohort
Participants
1,280 adults
Exposure
SGLT2 inhibitor plus guideline-directed medical therapy vs guideline-directed medical therapy without SGLT2 inhibitor
  • SGLT2 inhibitorsn = 640
  • No SGLT2 inhibitorn = 640reference
Outcome
Acute HF exacerbation and all-cause mortality
Follow-up
2-year follow-up
Methodological detailspropensity-score matched, TriNetX research network
  • Propensity-score matched
  • TriNetX research network

Main finding

As reported in the abstract

2-year follow-up
SGLT2 inhibitors vs No SGLT2 inhibitorOdds ratio (95% CI)P value
Acute HF exacerbation
0.483(0.36–0.65)
P < 0.001
All-cause mortality
0.296(0.22–0.40)
P = 0.001

Observational data: associations, not effects.

Further findings

OutcomeOR (95% CI)P value
All-cause hospitalizations or ED visits, AF/flutter, AKI, renal replacement therapy · 2-year follow-upSGLT2 inhibitorsvs No SGLT2 inhibitorAll-cause hospitalizations or ED visits0.479 (0.383–0.599)P < 0.001
All-cause hospitalizations or ED visits, AF/flutter, AKI, renal replacement therapy · 2-year follow-upSGLT2 inhibitorsvs No SGLT2 inhibitorAF/flutter0.397 (0.213–0.737)P = 0.003
All-cause hospitalizations or ED visits, AF/flutter, AKI, renal replacement therapy · 2-year follow-upSGLT2 inhibitorsvs No SGLT2 inhibitorAKI0.486 (0.382–0.619)P < 0.001
All-cause hospitalizations or ED visits, AF/flutter, AKI, renal replacement therapy · 2-year follow-upSGLT2 inhibitorsvs No SGLT2 inhibitorRenal replacement therapy0.398 (0.189–0.839)P = 0.012

Original publication

SGLT2 Inhibitor Use and Risk of Clinical Events in Patients With Cancer Therapy–Related Cardiac Dysfunction. JACC Heart Fail. Published 25 October 2023. doi:10.1016/j.jchf.2023.08.026

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