Key result
Canagliflozin prescription at discharge for acute heart failure was associated with a lower risk of heart failure hospitalization or cardiovascular death (HR 0.51; 95% CI 0.27-0.95; p<0.035).
Why the study?
SGLT2 inhibitors reduce the risk of HF hospitalization in T2D patients, but the impact of canagliflozin prescribed at discharge after acute HF hospitalization on re-hospitalization risk and NT-ProBNP changes required assessment.
Does canagliflozin prescribed at discharge reduce heart failure rehospitalization in patients with type 2 diabetes after hospitalization for acute heart failure?
Cohort (n=102)
No
Does canagliflozin prescribed at discharge reduce heart failure rehospitalization in patients with type 2 diabetes after hospitalization for acute heart failure?
Hazard Ratio: 0.51 (95% CI 0.27–0.95)
Absolute Event Rate: 37.8% vs 70.2%
p-value: p=< 0.035
Prescribing canagliflozin at discharge for patients with type 2 diabetes hospitalized for acute heart failure is associated with a significantly lower risk of heart failure readmission and cardiovascular death.
May support canagliflozin initiation at HF discharge in T2D; observational data leaves open need for randomized confirmation.
Background: Heart failure (HF) is one of the mayor contributors to cardiovascular morbidity and mortality in patients with diabetes. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated to reduce the risk of hospitalization for HF in patients with type 2 diabetes mellitus (T2D). We aimed to assess the risk for re-hospitalization in a cohort of patients hospitalized for HF according to whether or not they received canagliflozin at discharge, as well as changes in N-terminal pro–B-type natriuretic peptide (NT-ProBNP) concentration during follow-up. Methods: We conducted a retrospective longitudinal study at a tertiary centre including 102 consecutive T2D patients discharged for acute HF without contraindication for SGLT2 inhibitors. We compared adverse clinical events (HF rehospitalization and cardiovascular death) and NT-ProBNP changes according to canagliflozin prescription at discharge. Results: Among the 102 patients included, 45 patients (44.1%) were prescribed canagliflozin and the remaining 57 (55.9%) were not prescribed any SGLT2 inhibitors (control group). After a median follow-up of 22 months, 45 patients (44.1%) were hospitalized for HF. Most of the rehospitalizations occurred during the first year (37.3%). HF readmission at first year occurred in 10 patients (22.2%) in the canagliflozin group and 29 patients (49.1%) in the control group (hazard ratio (HR): 0.45; 95% confidence interval (CI): 0.21–0.96; p < 0.039). A composite outcome of hospitalization for HF or death from cardiovascular causes was lower in the canagliflozin group (37.8%) than in the control group (70.2%) (HR: 0.51; 95% CI: 0.27–0.95; p < 0.035). Analysis of NT-ProBNP concentration showed an interaction between canagliflozin therapy and follow-up time (p = 0.002). Conclusions: Canagliflozin therapy at discharge was associated with a lower risk of readmission for HF and a reduction in NT-ProBNP concentration in patients with diabetes after hospitalization for HF.
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Martín et al. (2021) conducted a cohort in Type 2 Diabetes after Hospitalization for Acute Heart Failure (n=102). Canagliflozin vs. No SGLT2 inhibitors was evaluated on Composite outcome of hospitalization for HF or death from cardiovascular causes (HR 0.51, 95% CI 0.27-0.95, p=< 0.035). Canagliflozin prescription at discharge for acute heart failure was associated with a lower risk of heart failure hospitalization or cardiovascular death (HR 0.51; 95% CI 0.27-0.95; p<0.035).
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