A Comparison of the Effects of SGLT2 Inhibitors in Heart Failure Patients with Diabetes Versus Non-diabetic Patients

Aim: To evaluate the effects of dapagliflozin in patients with HFrEF with and without diabetes. Methodology: A case-control study was conducted at the department of Cardiology, Liaquat University Hospital, Hyderabad between February 2020 to August 2020 for a duration of six months. A dose of 10 mg of dapagliflozin were added to the standard therapeutic regimes of all patients. Primary outcome was the composite of an attack of worsening heart failure, or death due to cardiovascular causes. SPSS v 26 was used to run data analysis. Results: The rate of cardiovascular death, hospitalization for heart failure (HHF), or an urgent heart failure visit in patients with DMT2 was 20% which was higher than the group without diabetes (13.3%). The rate of hospitalization for heart failure in patients with DMT2 was 13.33% which was higher than the group without diabetes (7.5%). The rate of cardiovascular death in patients with DMT2 was 14 (11.67%) while in the group without DMT2 10 (8.33%) patients died because of cardiovascular complications during the study period. Number of first and recurrent hospitalizations for heart failure and cardiovascular death were significantly higher in individuals with diabetes compared to those without i.e. 37 (30.83%) vs 22 (18.33%) with a p=0.025. Conclusion: The impact of dapagliflozin on the primary and secondary outcomes did not significantly alter in patients with and without diabetes mellitus type 2. However, SGLT2 inhibitor - dapagliflozin caused significantly lower rates of first and recurrent heart failure hospitalizations and cardiovascular death in individuals without diabetes in comparison to those with diabetes.