SGLT2i and primary prevention of cancer therapy–related cardiac dysfunction in patients with diabetes Journal Article
| Authors: | Bhatti, A. W.; Patel, R.; Dani, S. S.; Khadke, S.; Makwana, B.; Lessey, C.; Shah, J.; Al-Husami, Z.; Yang, E. H.; Thavendiranathan, P.; Neilan, T. G.; Sadler, D.; Cheng, R. K.; Dent, S. F.; Liu, J.; Lopez-Fernandez, T.; Herrmann, J.; Scherrer-Crosbie, M.; Lenihan, D. J.; Hayek, S. S.; Ky, B.; Deswal, A.; Barac, A.; Nohria, A.; Ganatra, S. |
| Article Title: | SGLT2i and primary prevention of cancer therapy–related cardiac dysfunction in patients with diabetes |
| Abstract: | Background: Specific cancer treatments can lead to cancer therapy–related cardiac dysfunction (CTRCD). Sodium glucose cotransporter-2 inhibitors (SGLT2is) can potentially prevent these cardiotoxic effects. Objectives: This study sought to determine whether SGLT2i use is associated with a lower incidence of CTRCD in patients with type 2 diabetes mellitus (T2DM) and cancer, exposed to potentially cardiotoxic antineoplastic agents, and without a prior documented history of cardiomyopathy or heart failure. Methods: We conducted a retrospective analysis of patients aged ≥18 years within the TriNetX database with T2DM, cancer, exposure to cardiotoxic therapies, and no prior documented history of cardiomyopathy or heart failure. Patients were categorized by SGLT2i use. After propensity score matching, outcomes were compared over 12 months using Cox proportional HRs. Subgroup analyses focusing on different cancer therapy classes were performed. Results: The study included 8,675 propensity-matched patients in each cohort (mean age = ∼65 years, 42% females, 71% White, ∼19% gastrointestinal malignancy, and ∼25% anthracyclines). Patients prescribed SGLT2is had a lower risk of developing CTRCD (HR: 0.76: 95% CI: 0.69-0.84). SGLT2is also reduced heart failure exacerbations (HR: 0.81; 95% CI: 0.72-0.90), all-cause mortality (HR: 0.67; 95% CI: 0.61-0.74), and all-cause hospitalizations/emergency department visits (HR: 0.93; 95% CI: 0.89-0.97). Subgroup analyses also demonstrated reduced CTRCD risk across various classes of cancer therapies in patients prescribed SGLT2is. Conclusions: SGLT2i administration was associated with a significantly decreased risk of developing CTRCD in patients with T2DM and cancer. © 2024 The Authors |
| Keywords: | controlled study; treatment outcome; aged; major clinical study; drug safety; treatment duration; comparative study; proteasome inhibitor; heart disease; incidence; aromatase inhibitor; cohort analysis; alkylating agent; retrospective study; cancer therapy; monoclonal antibody; protein tyrosine kinase inhibitor; prescription; hospitalization; population research; heart failure; patient coding; anthracycline derivative; observational study; risk reduction; atrial fibrillation; non insulin dependent diabetes mellitus; primary prevention; drug induced disease; antimetabolite; drug use; drug exposure; caucasian; cardiomyopathy; gastrointestinal cancer; medical history; propensity score; low risk patient; heart atrium flutter; antineoplastic therapy; human; male; female; article; canagliflozin; malignant neoplasm; all cause mortality; sodium glucose cotransporter 2 inhibitor; dapagliflozin; empagliflozin; cancer therapy related cardiac dysfunction; emergency department visit; ctrcd; sodium glucose co-transporter 2 inhibitors |
| Journal Title: | JACC: CardioOncology |
| Volume: | 6 |
| Issue: | 6 |
| ISSN: | 2666-0873 |
| Publisher: | American College of Cardiology |
| Date Published: | 2024-12-01 |
| Start Page: | 863 |
| End Page: | 875 |
| Language: | English |
| DOI: | 10.1016/j.jaccao.2024.08.001 |
| PROVIDER: | scopus |
| PMCID: | PMC11711834 |
| PUBMED: | 39801650 |
| DOI/URL: | |
| Notes: | Source: Scopus |
