Canagliflozin for Japanese patients with chronic heart failure and type II diabetes

Cardiovasc Diabetol. 2019 Jun 5;18(1):76. doi: 10.1186/s12933-019-0877-2.


Background: Reports that sodium glucose cotransporter 2 inhibitors decrease cardiovascular death and events in patients with diabetes have attracted attention in the cardiology field. We conducted a study of canagliflozin in patients with chronic heart failure and type II diabetes.

Methods: Thirty-five Japanese patients with chronic heart failure and type II diabetes were treated with canagliflozin for 12 months. The primary endpoints were the changes of subcutaneous, visceral, and total fat areas at 12 months determined by computed tomography. Secondary endpoints included markers of glycemic control, renal function, and oxidative stress, as well as lipid parameters, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), flow-mediated dilation (FMD), and echocardiographic left ventricular function.

Results: All fat areas (subcutaneous, visceral, and total) showed a significant decrease at 12 months. ANP and BNP also decreased significantly, along with improvement of renal function, oxidized LDL, and E/e', FMD increased significantly after canagliflozin treatment.

Conclusion: Canagliflozin demonstrated cardiac and renal protective effects as well as improving oxidative stress, diastolic function, and endothelial function. This drug was effective in patients who had heart failure with preserved ejection fraction and could become first-line therapy for such patients with diabetes. Trial registration UMIN ( ), Study ID: UMIN000021239.

Keywords: Diabetes; Heart failure; SGLT2 inhibitor.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adiposity / drug effects
  • Aged
  • Aged, 80 and over
  • Atrial Natriuretic Factor / blood
  • Biomarkers / blood
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Canagliflozin / adverse effects
  • Canagliflozin / therapeutic use*
  • Chronic Disease
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / mortality
  • Diabetes Mellitus, Type 2 / physiopathology
  • Female
  • Heart / drug effects*
  • Heart / physiopathology
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Humans
  • Japan
  • Kidney / drug effects
  • Kidney / physiopathology
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Prospective Studies
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Weight Loss / drug effects


  • Biomarkers
  • Blood Glucose
  • Sodium-Glucose Transporter 2 Inhibitors
  • Canagliflozin
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor

Associated data

  • JPRN/UMIN000021239