Heart health risks and outcomes after starting sodium glucose cotransporter 2 inhibitor treatment in a real-world population

Initiation of SGLT2 inhibitors was associated with a lower rate of all-cause mortality and hospitalization for heart failure compared to other antihyperglycemic agents.

• SGLT2i initiation resulted in 1.73 events per 100 person-years for all-cause mortality and hospitalization for heart failure, compared to 3.01 events per 100 person-years for non-SGLT2i.
• The hazard ratio for all-cause mortality and hospitalization for heart failure was 0.57, suggesting a significant reduction in risk.
• SGLT2i users experienced 2.31 major adverse cardiovascular events per 100 person-years, compared to 3.45 events per 100 person-years in non-SGLT2i users.
• The hazard ratio for major adverse cardiovascular events associated with SGLT2i use was 0.67, indicating a lower risk.
• SGLT2i initiation was linked to an approximately 2-fold higher risk of below-knee lower extremity amputation (0.17 versus 0.09 events per 100 person-years).
• Most amputations were associated with canagliflozin, suggesting variability in risk among different SGLT2i medications.

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