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.
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