SGLT2 Inhibitors and Cardiovascular Outcomes in Older, Anthracycline-Treated Patients With Cancer

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In a population-based cohort study reported in JACC: CardioOncology, Abdel-Qadir et al found that receipt of sodium glucose cotransporter-2 (SGLT2) inhibitors was associated with a reduced risk of hospitalization for heart failure—but not risk for heart failure—among patients aged ≥ 65 years with controlled diabetes and no history of heart failure who received anthracycline-based therapy for cancer.

Study Details

The study used Ontario administrative data sets to identify 99 patients who received SGLT2 inhibitors and 834 controls who did not among patients also receiving anthracycline-based therapy between January 2016 and December 2019.  

Key Findings

Median follow-up was 1.6 years (interquartile range = 0.8–2.9 years). There were no hospitalizations for heart failure in the SGLT2 inhibitor group vs 31 in the control group (hazard ratio [HR] = 0.0, P < .001). New heart failure diagnoses occurred in 6 patients in the SGLT2 inhibitor group vs 87 in the control group (HR = 0.55, 95% confidence interval [CI] = 0.23–1.31, P = .18).

A total of 74 hospitalizations with cardiovascular disease coded as one of the diagnoses were observed; the hazard ratio for the SGLT2 inhibitor group vs the control group was 0.39 (95% CI = 0.12–1.28, P = 0.12). Mortality rates per 100 person-years were 8.9 in the SGLT2 inhibitor group and 16.6 in the control group (HR = 0.63, 95% CI = 0.36–1.11, P = .11).

The investigators concluded, “SGLT2 [inhibitors] may reduce the rate of heart failure[–related] hospitalization after anthracycline-containing chemotherapy. This hypothesis warrants further testing in randomized controlled trials.”

Husam Abdel-Qadir, MD, PhD, of Women’s College Hospital, University of Toronto, and Paaladinesh Thavendiranathan, MD, MSc, of Ted Rogers Program in Cardiotoxicity Prevention, Toronto General Hospital, University of Toronto, are the corresponding authors for the JACC: CardioOncology article.

Disclosure: The study was supported by the Ted Rogers Centre for Heart Research, Heart and Stroke Foundation of Canada, and others. For full disclosures of the study authors, visit

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