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CANVAS Cardiovascular Risk Reduction Algorithm

  • Time horizon (years)
  • Choose baseline event-rate source
  • Baseline annual MACE rate (per 1000 patient-years)
  • Baseline annual HHF rate (per 1000 patient-years)
  • Baseline annual CV death or HHF rate (per 1000 patient-years)
  • CANVAS Cardiovascular Risk Reduction Algorithm — Explanation and Clinical Context
    The CANVAS Program (integrated CANVAS and CANVAS-R trials) randomized patients with type 2 diabetes at high cardiovascular risk to canagliflozin versus placebo on top of standard of care. In the integrated analysis the annualized rate of the primary composite (major adverse cardiovascular events — CV death, nonfatal myocardial infarction, or nonfatal stroke) was approximately 31.5 per 1000 patient-years in the placebo arm and 26.9 per 1000 patient-years in the canagliflozin arm (hazard ratio 0.86). Hospitalization for heart failure and the composite of CV death or HF hospitalization showed larger relative reductions (e.g., HHF HR ≈ 0.67).

    This calculator lets you apply those published trial relative effects to a baseline absolute risk (either the CANVAS population average or a custom clinician-supplied baseline rate) and compute estimated absolute risk reduction, events prevented per 1,000 patients over a chosen time horizon, and an approximate NNT. It is intentionally transparent: rather than attempting to re-implement a complex parametric patient-level model (which requires published coefficients and careful external validation), it uses the CANVAS trial effect sizes with clear assumptions so you can quickly see likely absolute benefits in your patient population.

    Reference:
    Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377:644–657. doi:10.1056/NEJMoa1611925.
    Willis M, Asseburg C, Slee A, Nilsson A, Neslusan C. Macrovascular Risk Equations Based on the CANVAS Program. Pharmacoeconomics. 2021 Apr;39(4):447-461. doi:10.1007/s40273-021-01001-0.