scholarly journals Optimizing Sodium-Glucose Co-transporter 2 Inhibitor Use in Patients with Heart Failure with Reduced Ejection Fraction: A Collaborative Clinical Practice Statement

2021 ◽  
pp. 100183
Author(s):  
Bruce A. Warden ◽  
Johannes Steiner ◽  
Albert Camacho ◽  
Khoa Nguyen ◽  
Jonathan Q Purnell ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

scholarly journals 257 Sodium-glucose CO-transporter-2 inhibitors eligibility in patients with heart failure with reduced ejection fraction

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Ilaria Ferrari ◽  
Francesco Cicogna ◽  
Claudia Tota ◽  
Leonardo Calò ◽  
Luca Monzo
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Ejection Fraction ◽  
Real World ◽  
Sglt2 Inhibitors ◽  
Diabetic Patients ◽  
World Population ◽  
Limited Data ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

Abstract Aims The sodium–glucose co-transporter-2 (SGLT2) inhibitors dapagliflozin and empagliflozin have been demonstrated to reduce adverse cardiovascular outcomes in patients with heart failure with reduced ejection fraction (HFrEF). Limited data are available characterizing the generalizability of SGLT2 inhibitors treatment in the clinical practice. The aim of the study was to evaluate the proportion of outpatients with HFrEF that would be eligible for SGLT2 inhibitors in a contemporary real-world population. Methods and results We retrospectively evaluated patients with chronic stable HFrEF followed-up at the HF outpatient clinic of our institution. Patients’ eligibility was assessed according to the entry criteria of DAPA-HF (dapagliflozin) and EMPEROR-Reduced (empagliflozin) trials and to US Food and Drug Administration (FDA) label criteria (only dapagliflozin). A total of 441 HFrEF patients was enrolled. According to the major inclusion and exclusion criteria from DAPA-HF and EMPEROR-Reduced trials, 198 (45%) patients would be candidates for initiation of both dapagliflozin and empagliflozin, 61 (14%) would be eligible only to dapagliflozin and 23 (5%) only to empagliflozin, without significant differences between diabetic and non-diabetic patients (P = 0.23). Among patients not suitable for gliflozins treatment (159 patients; 36%), the major determinant of ineligibility was the failure to achieve the predefined NT-proBNP inclusion threshold. Excluding NTproBNP as per FDA label criteria, dapagliflozin eligibility increased to 86%. Conclusions In our real-world analysis a large proportion of HFrEF patients would be candidates for initiation of SGLT2 inhibitors, supporting its broad generalizability in clinical practice. This would be expected to reduce morbidity and mortality in eligible patients.

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