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A reduction in CV death and heart failure (HF) is reported with SGLT-2i in patients
with T2D and established CV disease (CVD). Using observational data from clinical
practice, we compared HF and death in patients with and without prior CVD of HF in
new users of SGLT-2i and other glucose lowering drugs (oGLD) in the US, UK, Sweden,
Norway and Denmark. 1:1 propensity score matching was applied. HF and death were collected
via medical records (UK), medical claims, electronic health and death records (US),
and national registers (Nordics). Hazard ratios (HR) for HF, death, and the composite
were estimated by country and pooled as a weighted average. After matching, baseline
characteristics were balanced between groups. 306,156 patients, > 150,000 person years
(PY) (100,947 PY for SGLT-2i; 89,208 PY for oGLD) and 950 new HF events were analyzed.
SGLT-2i, when compared to oGLD, was associated with lower rates of HF in patients
with and without CVD (HR 0.69; 95% CI 0.59–0.80; HR 0.55 95% CI 0.34–0.88). Similar
results were seen for death and death/HF irrespective of CVD or HF history. Findings
were consistent across countries with varying SGLT-2i class composition. In this large
cohort of patients with and without CVD, SGLT-2i was associated with significant reduction
in HF and death vs oGLD. This suggests that the benefit of SGLT-2i applies to a broad
population of patients with T2D.
Figure 1Pooled hazard ratios from meta-analyses for heart failure in subjects with and without
established CVD* and HF respectively at initiation of the index drug in five countries:
US, UK, Sweden, Norway and Denmark. Analyses of first events on treatment.
