Treatment with a sodium glucose cotransporter-2 (SGLT-2) inhibitor was associated with a marked reduction in hospitalisation for heart failure (HHF) when compared with treatment with other glucose-lowering drugs, according to research presented at the ACC conference.

In a large, real-world study across six countries, non-parsimonious propensity scores for SGLT-2 inhibitors initiation were used to match groups in which a broad population of patients with type 2 diabetes received either SGLT-2 inhibitors or other glucose-lowering drugs treatment. The incidence of HHF was collected via primary care and hospital records in the UK and Germany, medical claims and electronic health records in the US and national registries in Sweden, Norway and Denmark. Hazard ratios for HHF were estimated by country and database and pooled in a meta-analysis.

The study included 364,828 patients, evenly divided between each treatment group, with a mean age of 57 years and 44% were women. At baseline, 3% had HF, 13% established cardiovascular disease, and 27% had microvascular disease.

For the primary endpoint of HHF, there was a reduction that favored the SGLT-2 inhibitors in each country. In total, there were 961 HHF during the study period, and the incidence was lower with the SGLT-2 inhibitors (hazard ratio [HR], 0.61; p < 0.001). The SGLT-2 inhibitor was also associated with a lower incidence of the secondary endpoint of all-cause death in each country and the total number was 1,334 (HR, 0.49; p < 0.001) and the secondary endpoint of HHF or all-cause death (1,983 events; HR, 0.54; p < 0.001).