TY - JOUR
T1 - Effect of Sotagliflozin on Early Mortality and Heart Failure-Related Events
T2 - A Post Hoc Analysis of SOLOIST-WHF
AU - SOLOIST-WHF Investigators
AU - Pitt, Bertram
AU - Bhatt, Deepak L.
AU - Szarek, Michael
AU - Cannon, Christopher P.
AU - Leiter, Lawrence A.
AU - McGuire, Darren K.
AU - Lewis, Julia B.
AU - Riddle, Matthew C.
AU - Voors, Adriaan A.
AU - Metra, Marco
AU - Lund, Lars H.
AU - Komajda, Michel
AU - Testani, Jeffrey M.
AU - Wilcox, Christopher S.
AU - Ponikowski, Piotr
AU - Lopes, Renato D.
AU - Ezekowitz, Justin A.
AU - Sun, Franklin
AU - Davies, Michael J.
AU - Verma, Subodh
AU - Kosiborod, Mikhail N.
AU - Steg, Ph Gabriel
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/8
Y1 - 2023/8
N2 - Background: Approximately 25% of patients admitted to hospitals for worsening heart failure (WHF) are readmitted within 30 days. Objectives: The authors conducted a post hoc analysis of the SOLOIST-WHF (Effect of Sotagliflozin on Cardiovascular Events in Patients With Type 2 Diabetes Post-WHF) trial to evaluate the efficacy of sotagliflozin versus placebo to decrease mortality and HF-related events among patients who began study treatment on or before discharge from their index hospitalization. Methods: The main endpoint of interest was cardiovascular death or HF-related event (HF hospitalization or urgent care visit) occurring within 90 and 30 days after discharge for the index WHF hospitalization. Treatment comparisons were by proportional hazards models, generating HRs, 95% CIs, and P values. Results: Of 1,222 randomized patients, 596 received study drug on or before their date of discharge. Sotagliflozin reduced the main endpoint at 90 days after discharge (HR: 0.54 [95% CI: 0.35-0.82]; P = 0.004) and at 30 days (HR: 0.49 [95% CI: 0.27-0.91]; P = 0.023) and all-cause mortality at 90 days (HR: 0.39 [95% CI: 0.17-0.88]; P = 0.024). In subgroup analyses, sotagliflozin reduced the 90-day main endpoint regardless of sex, age, estimated glomerular filtration rate, N-terminal pro-B-type natriuretic peptide, left ventricular ejection fraction, or mineralocorticoid receptor agonist use. Sotagliflozin was well-tolerated but with slightly higher rates of diarrhea and volume-related events than placebo. Conclusions: Starting sotagliflozin before discharge in patients with type 2 diabetes hospitalized for WHF significantly decreased cardiovascular deaths and HF events through 30 and 90 days after discharge, emphasizing the importance of beginning sodium glucose cotransporter treatment before discharge.
AB - Background: Approximately 25% of patients admitted to hospitals for worsening heart failure (WHF) are readmitted within 30 days. Objectives: The authors conducted a post hoc analysis of the SOLOIST-WHF (Effect of Sotagliflozin on Cardiovascular Events in Patients With Type 2 Diabetes Post-WHF) trial to evaluate the efficacy of sotagliflozin versus placebo to decrease mortality and HF-related events among patients who began study treatment on or before discharge from their index hospitalization. Methods: The main endpoint of interest was cardiovascular death or HF-related event (HF hospitalization or urgent care visit) occurring within 90 and 30 days after discharge for the index WHF hospitalization. Treatment comparisons were by proportional hazards models, generating HRs, 95% CIs, and P values. Results: Of 1,222 randomized patients, 596 received study drug on or before their date of discharge. Sotagliflozin reduced the main endpoint at 90 days after discharge (HR: 0.54 [95% CI: 0.35-0.82]; P = 0.004) and at 30 days (HR: 0.49 [95% CI: 0.27-0.91]; P = 0.023) and all-cause mortality at 90 days (HR: 0.39 [95% CI: 0.17-0.88]; P = 0.024). In subgroup analyses, sotagliflozin reduced the 90-day main endpoint regardless of sex, age, estimated glomerular filtration rate, N-terminal pro-B-type natriuretic peptide, left ventricular ejection fraction, or mineralocorticoid receptor agonist use. Sotagliflozin was well-tolerated but with slightly higher rates of diarrhea and volume-related events than placebo. Conclusions: Starting sotagliflozin before discharge in patients with type 2 diabetes hospitalized for WHF significantly decreased cardiovascular deaths and HF events through 30 and 90 days after discharge, emphasizing the importance of beginning sodium glucose cotransporter treatment before discharge.
KW - SGLT2 inhibitor
KW - dual SGLT1 and SGLT2 inhibitor
KW - heart failure-related events
KW - hospital readmission
KW - mortality
KW - sotagliflozin
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UR - http://www.scopus.com/inward/citedby.url?scp=85166556987&partnerID=8YFLogxK
U2 - 10.1016/j.jchf.2023.05.026
DO - 10.1016/j.jchf.2023.05.026
M3 - Article
C2 - 37558385
AN - SCOPUS:85166556987
SN - 2213-1779
VL - 11
SP - 879
EP - 889
JO - JACC: Heart Failure
JF - JACC: Heart Failure
IS - 8
ER -