{"id":"5aa8653d040e","type":"article","url":"https://hartvaat.nl/2018/07/31/canagliflozine-en-hartfalen-bij-diabetes-type-2-canvas-programma/","title":"Canagliflozine en hartfalen bij diabetes type 2: CANVAS programma","title_en":"Canagliflozin and Heart Failure in Type 2 Diabetes Mellitus: Results From the CANVAS Program.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":["canagliflozine","empagliflozine","sglt2-remmers"],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.118.034222","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.118.034222","authors":["Karin Rådholm","Gemma Figtree","Vlado Perkovic","Scott D Solomon","Kenneth W Mahaffey","Dick de Zeeuw","Greg Fulcher","Terrance D Barrett","Wayne Shaw","Mehul Desai","David R Matthews","Bruce Neal"],"significance":8,"published":"2018-07-31","source_date":"2018-07-31","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/palliatief-hartfalen/","https://hartvaat.nl/kennis/farmacologie/sglt2-remmers-cardiovasculaire-trials/"],"congress":"","summary_en":"This CANVAS heart failure analysis confirmed that canagliflozin reduces heart failure hospitalization and cardiovascular death in patients with type 2 diabetes, with consistent benefit regardless of baseline heart failure history. The data added to the growing evidence for SGLT2 inhibitors as heart failure preventive therapy.","created":"2026-07-03T10:27:23Z","updated":"2026-07-03T13:26:38Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"CANVAS-analyse specifiek gericht op hartfalenuitkomsten met canagliflozine bij diabetes type 2. Bevestigt het HF-preventieve effect van SGLT2-remming.","abstract_original":"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."}