Impact of sodium-glucose cotransporter-2 inhibitors on heart failure and mortality in patients with cancer

Cho-Han Chiang, Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts, USA
Cho-Hung Chiang, Department of General Division, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Taipei, Taiwan.
Cho-Hsien Chiang, Department of Medical Education, Kuang Tien General Hospital, Taichung, Taiwan.
Kevin Sheng-Kai Ma, Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Chun-Yu Peng, Department of Medicine, Danbury Hospital, Danbury, Connecticut, USA.
Yuan Ping Hsia, Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Taipei, Taiwan.
Chuan-Sheng Horng, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
Cheng-Ying Chen, Department of Medical Education, Cathay General Hospital, Taipei, Taiwan.
Yu-Cheng Chang, Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
XinYa See, Rochester Regional HealthFollow
Yuan-Jen Chen, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Shih-Syuan Wang, Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
Giselle A. Suero-Abreu, Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
L R. Peterson, Department of Medicine and Radiology, Washington University in St Louis School of Medicine, St Louis, Missouri, USA.
Paaladinesh Thavendiranathan, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Center, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
Philippe Armand, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Cheng-Ming Peng, Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
Her-Shyong Shiah, Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
Tomas G. Neilan, Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

Department

Medicine

Document Type

Article

Publication Title

Heart (British Cardiac Society)

Abstract

Objectives: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce heart failure (HF) in at-risk patients and may possess antitumour effects. We examined the effect of SGLT2i on HF and mortality among patients with cancer and diabetes.

Methods: This was a retrospective propensity score-matched cohort study involving adult patients with type 2 diabetes mellitus diagnosed with cancer between January 2010 and December 2021. The primary outcomes were hospitalisation for incident HF and all-cause mortality. The secondary outcomes were serious adverse events associated with SGLT2i.

Results: From a total of 8640 patients, 878 SGLT2i recipients were matched to non-recipients. During a median follow-up of 18.8 months, SGLT2i recipients had a threefold lower rate of hospitalisation for incident HF compared with non-SGLT2i recipients (2.92 vs 8.95 per 1000 patient-years, p=0.018). In Cox regression and competing regression models, SGLT2i were associated with a 72% reduction in the risk of hospitalisation for HF (HR 0.28 (95% CI: 0.11 to 0.77), p=0.013; subdistribution HR 0.32 (95% CI: 0.12 to 0.84), p=0.021). The use of SGLT2i was also associated with a higher overall survival (85.3% vs 63.0% at 2 years, p< 0.001). The risk of serious adverse events such as hypoglycaemia and sepsis was similar between the two groups.

Conclusions: The use of SGLT2i was associated with a lower rate of incident HF and prolonged overall survival in patients with cancer with diabetes mellitus.

First Page

470

Last Page

477

DOI

10.1136/heartjnl-2022-321545

Volume

109

Issue

6

Publication Date

2-23-2023

PubMed ID

36351793

Link to Full Text

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