Patients with chronic heart failure fare better when treated with sodium-glucose co-transporter-2 (SGLT2) inhibitors. There was no information on the benefit of SGLT2 inhibitors among patients treated with anthracyclines, despite basic science research that supported their use. This research aimed to examine the cardiac benefits and side effects of SGLT2 inhibitors for patients receiving anthracycline therapy. Patients with both cancer and DM who were given anthracyclines were found in this investigation. Patients with cancer and diabetes mellitus taking an SGLT2 inhibitor while being treated with anthracyclines (n=32) were the cases. Patients with cancer and DM who were also being treated with anthracyclines but were not receiving an SGLT2 inhibitor served as controls (n=96). An aggregate of cardiac events (incidence of heart failure, hospitalizations for heart failure, new cardiomyopathy (>10% drop in ejection fraction to <53%], and clinically significant arrhythmias) was considered the major cardiac outcome. Mortality rates were the most important measure of risk. There were no statistically significant differences between groups with respect to age, sex, ethnicity, cancer type, cancer stage, or any other known cardiac risk factors. About 20  cardiac incidents occurred during a median follow-up period of 1.5 years. Case patients had a decreased rate of cardiac events (3%) compared to the control group (20%) (P=0.025). Overall mortality was lower in the case patients than in controls (9% vs. 43%; P<0.001), and a composite of sepsis and neutropenic fever was lower in the case group than in the control group (16% vs. 40%; P=0.013). Patients with cancer and DM who were treated with anthracyclines had a reduced risk of cardiac events when using an SGLT2 inhibitor. Furthermore, SGLT2 inhibitors seemed to have no adverse side effects. These findings supported the idea that a randomized clinical study of SGLT2 inhibitors in high-cardiac-risk individuals receiving anthracyclines would be worthwhile.

Source: sciencedirect.com/science/article/abs/pii/S2213177922002384