Takeaway
- Canagliflozin (e.g., Invokana)
reduces overall risk for heart failure (HF) events in patients with type 2 diabetes (T2D) and high cardiovascular risk. - The results show no risk reduction differences between preserved vs reduced ejection fraction (EF).
Why this matters
- Patients with T2D are at high risk for HF.
- Sodium glucose cotransporter 2 inhibitors reduce HF events in patients with T2D and cardiovascular disease, but differences between HF with preserved vs reduced EF (HFpEF vs HFrEF) are unclear.
Study design
- Data from the CANagliflozin cardioVascular Assessment
Study Program, including 10,142 patients with mean 188.2-week follow-up. - HFpEF: HF event with EF ≥50%; HFrEF: HF event with EF <50% documented during HF admission, or prior reduced EF report with no documented evidence of recovery.
- Other events defined as HF with unknown EF (HFuEF).
- Funding: Janssen Research and Development, LLC.
Key results
- Overall 2.7% (276) had a fatal or hospitalized HF event during follow-up; 0.60% (61) had >1 HF event.
- Canagliflozin reduced fatal or hospitalized HF events vs placebo:
- HR, 0.70 (95% CI, 0.55-0.89).
- Event HRs (95% CIs) for canagliflozin vs placebo were:
- HFrEF: 0.69 (0.48-1.00);
- HFpEF: 0.83 (0.55-1.25); and
- HFuEF: 0.54 (0.32-0.89).
Limitations
- EF measurements only at time of event, not baseline.
References
References