Key result
SGLT2 inhibitors were associated with significantly lower all-cause mortality compared to non-SGLT2i use in adults with T2DM and heart failure on diuretics (HR 0.49; 95% CI 0.29-0.83; p=0.008).
Why the study?
Studies assessing the renal protection of SGLT2 inhibitors in patients with type 2 diabetes mellitus and heart failure on diuretics were limited.
Do SGLT2 inhibitors reduce all-cause mortality and renal impairments in adults with T2DM and HF using diuretics?
Cohort (n=366)
No
Do SGLT2 inhibitors reduce all-cause mortality and renal impairments in adults with T2DM and HF using diuretics?
Hazard Ratio: 0.49 (95% CI 0.29–0.83)
p-value: p=0.008
In a real-world cohort of patients with T2DM and HF on diuretics, SGLT2 inhibitors were associated with significantly reduced all-cause mortality and renal progression.
Supports SGLT2i benefit on mortality and renal outcomes in diuretic-treated T2DM-HF; hypothesis-generating, requires randomized confirmation.
Previous studies about renal protection of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in type 2 diabetes mellitus (T2DM) patients with heart failure (HF) on diuretics were still limited. The goal of the study is to survey the efficacy of SGLT2i to reduce all-cause mortality and renal impairments in patients with T2DM and HF using diuretics. The retrospective cohort study was analyzed from Kaohsiung Medical University Hospital Research Database (KMUHRD) in Taiwan. Adults with T2DM and HF using any diuretics at least 28 days during 2016-2018 were enrolled and then divided into the SGLT2i group and the non-SGLT2i group. Propensity score matching was used to balance baseline characteristics between the two groups. The primary outcome was all-cause mortality. Secondary outcomes contained dialysis occurrence, renal progression, and acute kidney injury (AKI). After 1:1 matching, there were 183 patients in each group respectively. When compared with the non-SGLT2i group, the SGLT2i group had significantly lower all-cause mortality (hazard ratios [HR]: 0.49, 95% CI 0.29-0.83, p = 0.008) and reduction of renal progression (HR: 0.30, 95% CI 0.12-0.75, p = 0.010). SGLT2i showed the trend to decrease dialysis occurrence (HR: 0.83, 95% CI 0.20-3.47, p = 0.797) and an increase in AKI (HR: 1.38, 95% CI 0.67-2.87, p = 0.383) but without significance. SGLT2 inhibitors were associated with reduced all-cause mortality and less renal progression with significance in T2DM patients with HF on diuretics.
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Weng et al. (2023) conducted a cohort in Type 2 diabetes mellitus and heart failure on diuretics (n=366). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) vs. Non-SGLT2i was evaluated on All-cause mortality (HR 0.49, 95% CI 0.29-0.83, p=0.008). SGLT2 inhibitors were associated with significantly lower all-cause mortality compared to non-SGLT2i use in adults with T2DM and heart failure on diuretics (HR 0.49; 95% CI 0.29-0.83; p=0.008).
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