Effect of Sotagliflozin on Early Mortality and Heart Failure-Related Events: A Post Hoc Analysis of SOLOIST-WHF

Authors

Bertram Pitt
Deepak L Bhatt
Michael Szarek
Christopher P Cannon
Lawrence A Leiter
Darren K McGuire
Julia B Lewis
Matthew C Riddle
Adriaan A Voors
Marco Metra
Lars H Lund
Michel Komajda
Jeffrey M Testani
Christopher S Wilcox
Piotr Ponikowski
Renato D Lopes
Justin A Ezekowitz
Franklin Sun
Michael J Davies
Subodh Verma
Mikhail N Kosiborod
Ph Gabriel Steg
SOLOIST-WHF Investigators

Language

English

Publication Date

8-1-2023

Journal

JACC: Heart Failure

DOI

10.1016/j.jchf.2023.05.026

PMID

37558385

Abstract

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.

Keywords

Humans, Diabetes Mellitus, Type 2, Heart Failure, Hospitalization, Stroke Volume, Ventricular Function, Left, Glycosides, SGLT2 inhibitor, dual SGLT1 and SGLT2 inhibitor, heart failure-related events, hospital readmission, mortality, sotagliflozin

Published Open-Access

yes

Recommended Citation

Pitt, Bertram; Bhatt, Deepak L; Szarek, Michael; et al., "Effect of Sotagliflozin on Early Mortality and Heart Failure-Related Events: A Post Hoc Analysis of SOLOIST-WHF" (2023). Faculty, Staff and Student Publications. 5512.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5512