Comparison of Canagliflozin, Dapagliflozin and Empagliflozin Added to Heart Failure Treatment in Decompensated Heart Failure Patients With Type 2 Diabetes Mellitus

Abstract

beneficial effect as a class effect on HF condition. 13,14 It remains unclear, however, whether the 3 SGLT2i are similarly effective for HF itself in patients with T2DM. As a preliminary step in the observation of the long-term effectiveness of SGLT2i, it is necessary to confirm the efficacy and safety in the short term. Therefore, the goal of this study was to compare the short-term efficacy and safety of the 3 SGLT2i, canagliflozin, dapagliflozin and empagliflozin in acute decompensated HF patients with T2DM. Methods Subjects This was a single-center, non-randomized, open-label study. This study involved 81 patients who were hospitalized due to decompensated HF complicated with T2DM at Toyama University Hospital. The inclusion criteria were as follows: (1) chronic HF with guideline-directed medical therapy including angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB), β-blockers and diuretics; (2) glycated hemoglobin (HbA1c) before study intervention ≥6.1% in patients with T2DM; (3) age ≥20

Differences in outcomes of hospitalizations for heart failure after SGLT2 inhibitor treatment: effect modification by atherosclerotic cardiovascular disease

“…Recent studies have reported that inhibition of SGLT1 receptors in the heart may decrease hyperglycemia-induced generation of reactive oxygen species, leading to potential prevention of heart failure [ 53 , 54 ]. In addition, compared to empagliflozin, dapagliflozin did not increase plasma aldosterone and noradrenaline levels, which may also prove beneficial for the prevention of hHF [ 55 ].…”

Relationship Between HbA1c Level and Effectiveness of SGLT2 Inhibitors in Decompensated Heart Failure Patients with Type 2 Diabetes Mellitus

“…Overall study design was detailed previously. 14) In brief, the present study was a single-center, non-randomized, open-labeled prospective registry study investigating the short-term efficacy and safety of SGLT2i (canagliflozin, dapagliflozin, and empagliflozin) in diabetic patients with acute decompensated HF. Eligible patients satisfied the enrollment criteria; aged !20 years and T2DM, which was defined as satisfying HbA1c !6.5% or In order to investigate the relationship between the effectiveness of SGLT2i and glycemic control, we stratified the patient cohort using baseline HbA1c (Group H: HbA1c !6.9%; Group L: HbA1c < 6.9%).…”

“…A detailed assessment of this early response to SGLT2i, instead of a chronic response, would be a key to further clarify the clinical impact of SGLT2i therapy. 14) In this study, we investigated the detailed early response to SGLT2i therapy in patients with acute decompensated HF who were stratified by the degree of HbA1c.…”

Efficacy of Continuing SGLT2 Inhibitors on Outcomes in Patients with Acute Decompensated Heart Failure

“…[17][18][19] We previously reported that short-term SGLT2i therapy could successfully reduce the BNP level in HF patients. 16) The decrease in BNP level at an early stage of SGLT2i administration is presumed to reflect the acute diuretic effect. However, many previous studies, including ours, reported that the acute diuretic effect by SGLT2i is transient and unsustainable.…”

“…Our team previously reported that short-term SGLT2i therapy corrected volume overload and ameliorated symptomatic pulmonary congestion in patients with ADHF and T2DM. 16) In this study, we investigated the impact of long-term SGLT2i therapy in patients with ADHF and T2 DM.…”