Related Experiment Video
Updated: Feb 13, 2026
A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
Published on: February 28, 2013
Canagliflozin and Heart Failure in Type 2 Diabetes Mellitus: Results From the CANVAS Program
Karin Rådholm1,2, Gemma Figtree, Vlado Perkovic2,3
1Department of Medicine and Health Sciences, Division of Community Medicine, Primary Care, Faculty of Health Sciences, Department of Local Care West, County Council of Ötergötland, Linköping University, Sweden (K.R.).
Insights
Canagliflozin significantly reduced cardiovascular death or heart failure hospitalization in patients with type 2 diabetes. The benefits of this sodium glucose cotransporter 2 inhibitor appeared greater in those with a prior history of heart failure.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Canagliflozin is a sodium glucose cotransporter 2 inhibitor studied for cardiovascular risk reduction.
- Heart failure (HF) and cardiovascular death are significant concerns in patients with type 2 diabetes mellitus (T2DM).
Purpose of the Study:
- To evaluate the effects of canagliflozin on heart failure and cardiovascular death in T2DM patients.
- To assess if benefits differ based on baseline history of heart failure.
Main Methods:
- The CANVAS Program enrolled 10,142 high-risk T2DM participants randomly assigned to canagliflozin or placebo.
- Follow-up averaged 188 weeks, with primary endpoint being cardiovascular death or hospitalized HF.
- Subgroup analyses included participants with and without a history of HF at baseline.
Main Results:
- Canagliflozin reduced the composite of cardiovascular death or hospitalized HF (HR 0.78; 95% CI 0.67-0.91).
- Fatal or hospitalized HF (HR 0.70) and hospitalized HF alone (HR 0.67) were also reduced.
- A statistically significant interaction (P=0.021) indicated potentially greater benefit for cardiovascular death or hospitalized HF in patients with prior HF history (HR 0.61) versus those without (HR 0.87).
Conclusions:
- Canagliflozin demonstrates efficacy in reducing cardiovascular death or HF hospitalization across diverse T2DM subgroups.
- The drug's cardiovascular benefits may be more pronounced in patients with a baseline history of heart failure.
Background:
Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces the risk of cardiovascular events. We report the effects on heart failure (HF) and cardiovascular death overall, in those with and without a baseline history of HF, and in other participant subgroups.
Methods:
The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) enrolled 10 142 participants with type 2 diabetes mellitus and high cardiovascular risk. Participants were randomly assigned to canagliflozin or placebo and followed for a mean of 188 weeks. The primary end point for these analyses was adjudicated cardiovascular death or hospitalized HF.
Results:
Participants with a history of HF at baseline (14.4%) were more frequently women, white, and hypertensive and had a history of prior cardiovascular disease (all P<0.001). Greater proportions of these patients were using therapies such as blockers of the renin angiotensin aldosterone system, diuretics, and β-blockers at baseline (all P<0.001). Overall, cardiovascular death or hospitalized HF was reduced in those treated with canagliflozin compared with placebo (16.3 versus 20.8 per 1000 patient-years; hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.67-0.91), as was fatal or hospitalized HF (HR, 0.70; 95% CI, 0.55-0.89) and hospitalized HF alone (HR, 0.67; 95% CI, 0.52-0.87). The benefit on cardiovascular death or hospitalized HF may be greater in patients with a prior history of HF (HR, 0.61; 95% CI, 0.46-0.80) compared with those without HF at baseline (HR, 0.87; 95% CI, 0.72-1.06; P interaction =0.021). The effects of canagliflozin compared with placebo on other cardiovascular outcomes and key safety outcomes were similar in participants with and without HF at baseline (all interaction P values >0.130), except for a possibly reduced absolute rate of events attributable to osmotic diuresis among those with a prior history of HF ( P=0.03).
Conclusions:
In patients with type 2 diabetes mellitus and an elevated risk of cardiovascular disease, canagliflozin reduced the risk of cardiovascular death or hospitalized HF across a broad range of different patient subgroups. Benefits may be greater in those with a history of HF at baseline.
Clinical Trial Registration:
URL: https://www.clinicaltrials.gov . Unique identifiers: NCT01032629 and NCT01989754.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:29Heart Failure II: Pathophysiology
01:17Pathophysiology of Heart Failure
01:27Heart Failure I: Introduction
01:22Heart Failure VI: Adjunct Therapies