Heart failure hospitalization still a problem among diabetics

Among diabetic individuals, the incidence of hospitalization for heart failure (HHF) is low but not negligible, a new study finds. In addition, the use of sodium-glucose cotransporter 2 inhibitors (SGLT2is) could help suppress HHF.

Drawing from a contemporary administrative claims database in Japan, the researchers enrolled 23,340 patients who had started using oral glucose-lowering drugs for the treatment of type 2 diabetes mellitus. Participants were followed for a mean of 2.8 years, during which the incidence of HHF was monitored; the secondary outcome was hospitalization for either myocardial infarction (MI) or stroke.

During the observation period, a total of 681 HHFs were reported, resulting in an incidence rate of 10.4 per 1,000 person-years. Hospitalization for MI was lower at 267 cases (4.1 per 1,000 person-years), while that for stroke was only slightly higher (n=847 cases; 12.9 per 1,000 person-years).

The respective 5-year cumulative incidence rates were 5.4 percent, 1.9 percent, and 6.1 percent. When analysis was restricted to patients who had no diagnosis of cardiovascular disease at baseline, the resulting cumulative incidences were 4.6 percent, 1.6 percent, and 4.5 percent, respectively.

In a subset of patients (n=2,849), the researchers sought to quantify the potential effect of initiating SGLT2i treatment using published relative risk reduction estimates from two prior trials; all patients satisfied the eligibility criteria of these two trials.

In this subset, the cumulative case count of HHF without any external medication was estimated to be 97.1 over 5 years. If 75 percent of these patients were to be treated with SGLT2is, the resulting event count was predicted to drop to 75.6 over the same time span.