Heart failure & cardiomyopathies
The Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors in Patients Aged Over 80 Years with Heart Failure
Authors' conclusion
SGLT2 inhibitors reduce the risk of all-cause death and HFH without increasing adverse events, even in patients over 80 years old. It may be that SGLT2 inhibitors are effective and safe in patients who are basically hesitant to be introduced to SGLT2 inhibitors, such as those with high frailty, low nutritional status or very low bodyweight.
Study context
- Population
- Patients over 80 years old hospitalized for HF between 2018 and 2023 in Kokura Memorial Hospitalpatients over 80 years old hospitalized for HF
- Participants
- 1,559 participants
- Exposure
- SGLT2i group vs non-SGLT2i group
- SGLT2i groupn = 233
- non-SGLT2i groupn = 1,326reference
- Outcome
- Primary composite outcome:
- All-cause death
- Heart failure hospitalization (HFH)
- Follow-up
- 1 year post-discharge
Methodological detailsmultivariate Cox regression model
- Multivariate Cox regression model
Main finding
As reported in the abstract
P < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| All-cause death · 1 year post-discharge | 0.58 (0.39–0.87) | P < 0.01 | |
| HFH · 1 year post-discharge | 0.69 (0.52–0.91) | P < 0.01 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Subgroup analysis (age, diabetes, body mass index, left ventricular ejection fraction, clinical frailty scale, geriatric nutritional risk index)
- No significant interactions; SGLT2 inhibitors consistently reduced composite outcomes across all strata and did not increase safety composite outcomes at any strata
Safety
| Outcome | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Secondary safety composite outcome (ischaemic stroke, urinary tract infection and dehydration) · 1 year post-dischargeNot increased | 0.80 (0.49–1.29) | P = 0.36 | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
The Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors in Patients Aged Over 80 Years with Heart Failure. ESC Heart Fail. Published 20 January 2025. doi:10.
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