Impact of sodium-glucose cotransporter-2 inhibitors on heart failure and mortality in patients with cancer

Cho Han Chiang, Cho Hung Chiang, Cho Hsien Chiang, Kevin Sheng Kai Ma, Chun Yu Peng, Yuan Ping Hsia, Chuan Sheng Horng, Cheng Ying Chen, Yu Cheng Chang, Xin Ya See, Yuan Jen Chen, Shih Syuan Wang, Giselle A. Suero-Abreu, L. R. Peterson, Paaladinesh Thavendiranathan, Philippe Armand, Cheng Ming Peng, Her Shyong Shiah, Tomas G. Neilan

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objectives: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce heart failure (HF) in at-risk patients and may possess antitumour effects. We examined the effect of SGLT2i on HF and mortality among patients with cancer and diabetes. Methods: This was a retrospective propensity score-matched cohort study involving adult patients with type 2 diabetes mellitus diagnosed with cancer between January 2010 and December 2021. The primary outcomes were hospitalisation for incident HF and all-cause mortality. The secondary outcomes were serious adverse events associated with SGLT2i. Results: From a total of 8640 patients, 878 SGLT2i recipients were matched to non-recipients. During a median follow-up of 18.8 months, SGLT2i recipients had a threefold lower rate of hospitalisation for incident HF compared with non-SGLT2i recipients (2.92 vs 8.95 per 1000 patient-years, p=0.018). In Cox regression and competing regression models, SGLT2i were associated with a 72% reduction in the risk of hospitalisation for HF (HR 0.28 (95% CI: 0.11 to 0.77), p=0.013; subdistribution HR 0.32 (95% CI: 0.12 to 0.84), p=0.021). The use of SGLT2i was also associated with a higher overall survival (85.3% vs 63.0% at 2 years, p<0.001). The risk of serious adverse events such as hypoglycaemia and sepsis was similar between the two groups. Conclusions: The use of SGLT2i was associated with a lower rate of incident HF and prolonged overall survival in patients with cancer with diabetes mellitus.

Original languageEnglish
Pages (from-to)470-477
Number of pages8
Issue number6
StatePublished - Mar 2023


  • Heart failure


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