Canagliflozin use does not significantly reduce MI risk in diabetics: Study
Australia: The use of SGLT2 inhibitor canagliflozin does not significantly reduce the risk of myocardial infarction (MI) in the population of CANVAS Program and CREDENCE trial, finds a recent study. The study, published in the journal Cardiovascular Research, included patients with type 2 diabetes and history or high risk of cardiovascular disease (CANVAS Program) or type 2 diabetes and chronic kidney disease (CREDENCE).
Gemma A Figtree, University of Sydney, Sydney, Australia, and colleagues aimed to explore the potential impact of sodium glucose co-transporter 2 inhibition (SGLT2i) on the clinical features of patients presenting with myocardial infarction (MI) through a post-hoc analysis of CANVAS Program and CREDENCE trial given the benefit of SGLT2i.
The study included people with type 2 diabetes and history or high risk of cardiovascular disease (CANVAS Program) or type 2 diabetes and chronic kidney disease (CREDENCE). They were randomized to receive Canagliflozin 100 or 300 mg (combined in the analysis) or placebo.
MI events were adjudicated as ST-elevation myocardial infarction (STEMI), non-STEMI as well as type 1 MI or type 2 MI. 421 first MI events in the CANVAS Program and 178 first MI events in the CREDENCE trial were recorded (83 fatal, 128 STEMI, 431 non-STEMI, and 40 unknown).
Key findings of the study include:
- No benefit of canagliflozin compared with placebo on time to first MI event was observed (HR 0.89).
- Canagliflozin was associated with lower risk for non-STEMI (HR 0.78) but suggested a possible increase in STEMI (HR 1.55), with no difference in risk of type 1 or type 2 MI.
- There was no change in fatal MI (HR 1.22).
"Canagliflozin was not associated with a reduction in overall MI in the pooled CANVAS Program and CREDENCE trial population," wrote the authors. "The possible differential effect on STEMI and Non-STEMI observed in the CANVAS cohort warrants further investigation."
The study titled, "Effects of canagliflozin on myocardial infarction: a post hoc analysis of the CANVAS Program and CREDENCE trial," is published in the journal Cardiovascular Research.