Effects of canagliflozin on cardiovascular, renal, and safety outcomes in participants with type 2 diabetes and chronic kidney disease according to history of heart failure: Results from the CREDENCE trial

Am Heart J. 2021 Mar:233:141-148. doi: 10.1016/j.ahj.2020.12.008. Epub 2020 Dec 22.


We aimed to assess the efficacy and safety of canagliflozin in patients with type 2 diabetes and nephropathy according to prior history of heart failure in the Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation (CREDENCE) trial. We found that participants with a prior history of heart failure at baseline (15%) were more likely to be older, female, white, have a history of atherosclerotic cardiovascular disease, and use diuretics and beta blockers (all P < .001), and that, compared with placebo, canagliflozin safely reduced renal and cardiovascular events with consistent effects in patients with and without a prior history of heart failure (all efficacy P interaction >.150). These results support the efficacy and safety of canagliflozin in patients with type 2 diabetes and nephropathy regardless of prior history of heart failure.

Trial registration: ClinicalTrials.gov NCT02065791.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Age Factors
  • Aged
  • Canagliflozin / adverse effects
  • Canagliflozin / therapeutic use*
  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diuretics / therapeutic use
  • Double-Blind Method
  • Female
  • Heart Failure / complications*
  • Humans
  • Male
  • Middle Aged
  • Placebos / therapeutic use
  • Renal Insufficiency, Chronic / drug therapy*
  • Sex Factors
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use*


  • Adrenergic beta-Antagonists
  • Diuretics
  • Placebos
  • Sodium-Glucose Transporter 2 Inhibitors
  • Canagliflozin

Associated data

  • ClinicalTrials.gov/NCT02065791