Diabetes Therapy Associated With Increased Heart Failure Hospitalization Risk


A real-life analysis compared multiple antidiabetic medications for increased risk of heart failure hospitalization.

Novel oral antidiabetic drug classes are offering improved treatment options for type 2 diabetes mellitus. However, concerns remain regarding the safety of these drugs, especially as they relate to heart failure and hospitalizations.

Santosh Gautam, MD, HealthCore Inc (Wilmington, DE), and colleagues conducted a study to assess relative risk of heart failure hospitalization of sodium glucose co-transporter-2 (SGLT2) and dipeptidyl peptidase-4 (DPP4) inhibitors in patients with type 2 diabetes mellitus. The retrospective observational study utilized a national commercially insured claims database to sample patients receiving SGLT2 (n = 4899) or DPP4 (n = 9798) medications between 2013 and 2014.

The primary outcome was hospitalization for heart failure. Cox regression models were used to assess for risk. Propensity score matching (1:2) was used to adjust for potential confounding variables. Analyses were stratified by presence of baseline diabetes complications and age.

Both groups were followed for approximately 2 years. Results of the study were published in Cardiovascular Diabetology (online July 31, 2017; doi:10.1186/s12933-017-0575-x).

Researchers observed that the risk of heart failure hospitalization was lower among patients using SGLT2 in comparison with matched DPP4 users (2.0% vs 3.1%, respectively; adjusted hazard ratio, 0.68; 95% CI, 0.54-0.86; P = .001).


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Additionally, researchers found that heart failure hospitalization risk was 32% lower for new users of SGLT2 compared with users of DPP4.

On the contrary, the stratified analyses disclosed no risk difference among the majority of patients, including those aged less than 65 years (85% of the matched cohort) and those without prior complication (69% of the matched cohort).

Researchers concluded that in real-life scenarios, SGLT2 medication is less likely to cause heart failure hospitalizations than DPP4 medications. This finding holds true specifically among older patients and those with previous diabetes complications, they noted.—Zachary Bessette