Protective Influence of SGLT-2 Inhibitors Against Heart Failure in Type 2 Diabetes Mellitus Through Longitudinal Clinical Database Analysis

Nagy, Attila Csaba and Tóth, Ágnes and Bak, Natália and Ulambayar, Battamir and Ghanem, Amr Sayed and Sztanek, Ferenc (2024) Protective Influence of SGLT-2 Inhibitors Against Heart Failure in Type 2 Diabetes Mellitus Through Longitudinal Clinical Database Analysis. JOURNAL OF CLINICAL MEDICINE, 13 (23). No. 7093. ISSN 2077-0383

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Abstract

Background: Sodium–glucose co-transporter 2 (SGLT-2) inhibitors, initially designed for type 2 diabetes, promote glucose excretion and lower blood glucose. Newer analogs like empagliflozin and dapagliflozin improve cardiovascular outcomes through mechanisms other than glycemic control, including blood pressure reduction and anti-inflammatory effects. Given the high cardiovascular risk present in diabetes, our study aims to emphasize the cardioprotective benefits of SGLT-2 inhibitors as a preventive therapy for heart failure (HF) in high-risk T2DM patients. Methods: Using data from 2542 patients identified by the ICD-10 E11 code from 2016 to 2020, this longitudinal study excluded those with E10 codes or those undergoing insulin treatment to focus on non-insulin-dependent T2DM. a multiple logistic regression model assessed HF incidence while adjusting for demographics and HbA1c. Results: SGLT-2 inhibitor use significantly lowered the odds of heart failure events (OR = 0.55, 95% CI: 0.31–0.99, p = 0.046), with a significant difference by gender (OR = 0.45, 95% CI: 0.28–0.71, p = 0.001) and eGFR (OR = 0.98, 95% CI: 0.97–0.99, p = 0.004). Conclusions: The real-world data highlight SGLT-2 inhibitors as promising for HF prevention and broader cardiometabolic health in T2DM, with potential value in managing complex comorbid profiles.

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