In geriatric patients with acute heart failure, SGLT2 inhibitors reduced all-cause mortality (HR 0.61, p=0.002) and hospitalizations (HR 0.54, p<0.001) compared to standard care.
Cohort (n=496)
Yes
Does SGLT2 inhibitor therapy reduce mortality and hospitalizations in highly comorbid geriatric patients hospitalized for acute heart failure?
SGLT2 inhibitors are effective and well-tolerated in very elderly, highly comorbid patients with acute heart failure, significantly reducing mortality and hospitalizations.
Hazard Ratio: 0.61
p-value: p=0.002
Abstract Background and aims SGLT2i have shown beneficial effects in heart failure (HF) management, but data on their use in geriatric populations with high comorbidity remain limited. This study aimed to assess the real-world efficacy and safety of SGLT2i in older patients with HF. Methods This prospective multicenter study included 496 patients hospitalized for acute heart failure across three geriatric units. The mean age was 90 years, and the mean Charlson Comorbidity Index score was 8.21. Participants were divided into two groups: the "SGLT2i group" (n=260) receiving SGLT2i (empagliflozin or dapagliflozin) alongside standard HF treatment and the "Control group" (n=236) receiving only standard HF treatment. The primary outcomes were all-cause mortality, AHF hospitalizations, and adverse events over one year. Results The SGLT2i group had significantly lower all-cause mortality (HR 0.61, p=0.002) and AHF hospitalizations (HR 0.54, p0.001) compared to the control group. Adjusted analyses confirmed these benefits, especially in HFpEF (aHR 0.47, p0.001). Although the SGLT2i group had higher rates of urinary and genital infections, the treatment discontinuation rate was low (2.7%). Conclusion In geriatric HF patients, SGLT2i therapy was associated with substantial reductions in mortality and hospitalizations. The treatment was generally well tolerated, with an acceptable safety profile in this frail population.
Hacil et al. (Sat,) conducted a cohort in Acute heart failure (n=496). SGLT2 inhibitors (empagliflozin or dapagliflozin) vs. Standard HF treatment was evaluated on All-cause mortality (HR 0.61, p=0.002). In geriatric patients with acute heart failure, SGLT2 inhibitors reduced all-cause mortality (HR 0.61, p=0.002) and hospitalizations (HR 0.54, p<0.001) compared to standard care.
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