Eligibility of outpatients with chronic heart failure for sodium-glucose co-transporter-2 inhibitors

被引:11
|
作者
Angelini, Gianmarco [1 ]
Albanese, Miriam [1 ]
Ursi, Raffaella [1 ]
Lisi, Francesco [1 ]
Bellino, Maria Consiglia [1 ]
Amato, Luca [1 ]
Gioia, Margherita Ilaria [2 ]
Parisi, Giuseppe [3 ]
Brunetti, Natale Daniele [4 ]
Piazzolla, Giuseppina [5 ]
Ciccone, Marco Matteo [1 ]
Iacoviello, Massimo [4 ]
机构
[1] Univ Bari, Sch Cardiol, Piazza Giulio Cesare 11, I-70124 Bari, Italy
[2] Hosp Brindisi, Cardiol Unit, SS 7 Mesagne, I-72100 Brindisi, Italy
[3] Local Hlth Serv Bari, Dept Cardiol, Bari, Italy
[4] Univ Foggia, Dept Med & Surg Sci, Viale Luigi Pinto 1, I-71122 Foggia, Italy
[5] Univ Bari, Interdisciplinary Dept Med, Internal Med Unit, I-70124 Bari, Italy
来源
ESC HEART FAILURE | 2021年 / 8卷 / 04期
关键词
Type 2 diabetes mellitus; Sodium-glucose co-transporter inhibitor; Therapy; Heart failure; OUTCOMES;
D O I
10.1002/ehf2.13380
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have been shown to have a relevant role in the prevention of hospitalizations for heart failure and improvement in the life expectancy of patients with diabetes and outpatients with chronic heart failure (CHF) with reduced left ventricular ejection fraction, independently from the presence of type 2 diabetes mellitus (T2DM). The aim of our study was to evaluate in a real-world population the number of outpatients with CHF who meet the enrolment criteria of the main randomized controlled trials (RCT) published in the last 5 years and consequently identify the percentage of patients who could potential benefit from SGLT2i therapy. Methods and results: We retrospectively evaluated all consecutive outpatients referred for CHF. The diagnosis of T2DM was according to the latest European Society of Cardiology Guidelines. Clinical characteristics considered for the enrolment in the RCTs were recorded. We enrolled 515 patients, 384 (75%) of whom had a left ventricular ejection fraction (LVEF) <= 40%, 82 (16%) had pre-diabetes, and 187 (36%) had diabetes. Most of the patients with LVEF <= 40% met the criteria for the DAPA-HF trial (65%), and this percentage was even higher if the serum level of N-terminal pro-brain natriuretic peptide was not considered. A high percentage of patients with diabetes and LVEF > 40% met the criteria for the DECLARE (39%), CANVAS (47%), and EMPA-REG (30%) trials. Patients meeting the enrolment criteria of RCTs evaluating SGLT2i were also characterized by a high risk of heart failure events during follow-up. Conclusions: In spite of a low number of patients actually treated with SGLT2i, we observed that a high prevalence of patients with CHF met the clinical characteristics of RCTs that have demonstrated a beneficial effect of SGLT2i.
引用
收藏
页码:2951 / 2958
页数:8
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