Precision Prescribing of SGLT2 Inhibitors in Individuals With Type 2 Diabetes for Primary Prevention of Heart Failure: Model Development and Validation Study
Authors' conclusion
The SABRE model is an easily deployed clinical prediction model integrating trial evidence and allowing more precise targeting of SGLT2i for primary HF prevention in T2D.
Study context
- Population
- Individuals with T2D without atherosclerotic cardiovascular disease (ASCVD), heart failure (HF) or chronic kidney disease (CKD); UK primary care data 2013–2020
- Participants
- 57,368 vs 111,673
- Comparison
- SGLT2i vs comparator initiators
- SGLT2in = 57,368
- Comparatorn = 111,673reference
- Outcome
- Individual-level 5-year absolute HF benefit of SGLT2i predicted by the SGLT2i Absolute Benefit Response (SABRE) model (QDiabetes-HF absolute risk combined with trial meta-analysis HR 0.63 for HF hospitalization)
- Follow-up
- 5-year
Methodological detailsclinical prediction model, validation in UK primary care data with linked hospital and death records
- Clinical prediction model
- Validation in UK primary care data with linked hospital and death records
Performance
As reported in the abstract
SABRE model-predicted absolute HF benefit with SGLT2i
Predicted absolute HF benefit, range
<0.1% to 14.1%
Predicted absolute HF benefit, median (IQR)
1.0%
0.6–1.8%
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| New-onset HF30% lower risk; consistent with trial evidence | 0.70 (0.63–0.78) | |
| 0.512Hazard ratio (log scale) |
Relative HF benefit by baseline absolute HF risk
- Relative HF benefit did not vary by baseline absolute HF risk
- P = 0.82
Original publication
Precision Prescribing of SGLT2 Inhibitors in Individuals With Type 2 Diabetes for Primary Prevention of Heart Failure: Model Development and Validation Study. Diabetes Care. Published 20 May 2026. doi:10.
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