PMID- 33599357 OWN - NLM STAT- MEDLINE DCOM- 20210810 LR - 20210810 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) VI - 23 IP - 6 DP - 2021 Jun TI - Use of sodium-glucose co-transporter 2 inhibitors in patients with heart failure and type 2 diabetes mellitus: data from the Swedish Heart Failure Registry. PG - 1012-1022 LID - 10.1002/ejhf.2131 [doi] AB - AIMS: Use of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in real-world heart failure (HF) is poorly characterised. In contemporary patients with HF and type 2 diabetes mellitus (T2DM) we assessed over time SGLT2i use, clinical characteristics and outcomes associated with SGLT2i use. METHODS AND RESULTS: Type 2 diabetes patients enrolled in the Swedish HF Registry between 2016-2018 were considered. We performed multivariable logistic regression models to assess the independent predictors of SGLT2i use and Cox regression models in a 1:3 propensity score-matched cohort and relevant subgroups to investigate the association between SGLT2i use and outcomes. Of 6805 eligible HF patients with T2DM, 376 (5.5%) received SGLT2i, whose use increased over time with 12% of patients on treatment at the end of 2018. Independent predictors of SGLT2i use were younger age, HF specialty care, ischaemic heart disease, preserved kidney function, and absence of anaemia. Over a median follow-up of 256 days, SGLT2i use was associated with a 30% lower risk of cardiovascular (CV) death/first HF hospitalisation (hazard ratio 0.70, 95% confidence interval 0.52-0.95), which was consistent regardless of ejection fraction, background metformin treatment and kidney function. SGLT2i use was also associated with a lower risk of all-cause and CV death, HF and CV hospitalisation, and CV death/myocardial infarction/stroke. CONCLUSION: In a contemporary HF cohort with T2DM, SGLT2i use increased over time, was more common with specialist care, younger age, ischaemic heart disease, and preserved renal function, and was associated with lower mortality and morbidity. CI - (c) 2021 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Becher, Peter M AU - Becher PM AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. AD - Germany German Center of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lubeck, Hamburg, Germany. FAU - Schrage, Benedikt AU - Schrage B AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. AD - Germany German Center of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lubeck, Hamburg, Germany. FAU - Ferrannini, Giulia AU - Ferrannini G AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Benson, Lina AU - Benson L AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Butler, Javed AU - Butler J AD - Department of Medicine, University of Mississippi, Jackson, MS, USA. FAU - Carrero, Juan Jesus AU - Carrero JJ AD - Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. FAU - Cosentino, Francesco AU - Cosentino F AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. AD - Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden. FAU - Dahlstrom, Ulf AU - Dahlstrom U AD - Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. FAU - Mellbin, Linda AU - Mellbin L AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. AD - Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden. FAU - Rosano, Giuseppe M C AU - Rosano GMC AD - Department of Medical Sciences, IRCCS San Raffaele, Rome, Italy. FAU - Sinagra, Gianfranco AU - Sinagra G AD - Cardiovascular Department, Azienda Sanitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy. FAU - Stolfo, Davide AU - Stolfo D AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. AD - Cardiovascular Department, Azienda Sanitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy. FAU - Lund, Lars H AU - Lund LH AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. AD - Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden. FAU - Savarese, Gianluigi AU - Savarese G AUID- ORCID: 0000-0001-7732-0887 AD - Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. AD - Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210302 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) RN - 0 (Symporters) RN - 9NEZ333N27 (Sodium) RN - IY9XDZ35W2 (Glucose) SB - IM CIN - Eur J Heart Fail. 2021 Jun;23(6):1023-1025. PMID: 33779013 MH - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology MH - Glucose MH - *Heart Failure/drug therapy/epidemiology MH - Humans MH - Registries MH - Sodium MH - *Sodium-Glucose Transporter 2 Inhibitors MH - Sweden/epidemiology MH - *Symporters OTO - NOTNLM OT - HFmrEF OT - HFpEF OT - Heart failure OT - Outcomes OT - SGLT2 inhibitors OT - SwedeHF EDAT- 2021/02/19 06:00 MHDA- 2021/08/11 06:00 CRDT- 2021/02/18 08:39 PHST- 2021/02/05 00:00 [revised] PHST- 2020/12/04 00:00 [received] PHST- 2021/02/15 00:00 [accepted] PHST- 2021/02/19 06:00 [pubmed] PHST- 2021/08/11 06:00 [medline] PHST- 2021/02/18 08:39 [entrez] AID - 10.1002/ejhf.2131 [doi] PST - ppublish SO - Eur J Heart Fail. 2021 Jun;23(6):1012-1022. doi: 10.1002/ejhf.2131. Epub 2021 Mar 2.