Long‐term benefit of SGLT2 inhibitors to prevent heart failure hospitalization in patients with diabetes, with potential time‐varying benefit

Figures

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  FIGURE 1. Identification of study population. The figure shows numbers of patients in the study cohort after a screening procedure (i.e., some patients were excluded for the reasons shown in the figure).

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  FIGURE 2. Risk of hospitalization for heart failure and treatment with antidiabetic drugs. This figure indicates a decreased risk of heart failure hospitalization among users of SGLT2 inhibitors compared to users of other antidiabetic medications, adjusting for potential confounders in the stepwise selection model. Patients and controls were matched for sex, age group, year of cohort entry, and duration of treated diabetes. Stepwise selection model: HRs were adjusted for clinically relevant factors, including GFR stage, beta‐blocker and diuretic use, history of heart failure and atrial fibrillation, and key laboratory values (total protein and hemoglobin). CI, confidence interval; DPP‐4, dipeptidyl peptidase 4; GFR, glomerular filtration rate; GLP‐1, glucagon‐like peptide 1; HR, hazard ratio; SGLT2, sodium‐glucose cotransporter‐2.

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  FIGURE 3. Effect modification of SGLT2 inhibitor use on heart failure hospitalization stratified by baseline variables. This figure examines how baseline variables (listed in the left column) influence the risk of heart failure (HF) hospitalization and whether different patient characteristics (baseline variables) influence how SGLT2 inhibitors affect the risk of heart failure hospitalization (i.e., effect modification). We employed conditional logistic regression models with interaction terms for each baseline variable and SGLT2 inhibitor use. HRs and 95% CIs are presented for the baseline variables. p‐values for interaction terms indicate whether the association between a baseline variable and HF hospitalization risk differs according to SGLT2 inhibitor use status. The models were adjusted for clinically relevant confounders, including GFR stage, beta‐blocker and diuretic use, history of heart failure and atrial fibrillation, and key laboratory values (total protein and hemoglobin). ACE inhibitor, angiotensin‐converting enzyme inhibitor; ARB, angiotensin type II receptor blocker; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CCB, calcium…

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  FIGURE 4. Time‐varying hazard ratio of SGLT2 inhibitors for heart failure hospitalization. This figure shows HRs with 95% CIs for the association between SGLT2 inhibitor use and the risk of heart failure hospitalization over time. HRs were estimated using a Cox proportional hazards model in two separate cohorts matched by propensity score (greedy nearest neighbor and optimal matching). CI, confidence interval; HR, hazard ratio; SGLT2 inhibitor, sodium‐glucose cotransporter‐2 inhibitor.