SGLT2i showed 98.3% adherence and low mortality (17.7%) at 2 years in decompensated HFrEF; no mortality difference between dapagliflozin and empagliflozin.
Does dapagliflozin compared to empagliflozin affect mortality and re-hospitalization in patients with decompensated HFrEF?
In a real-world cohort of patients with decompensated HFrEF, SGLT2 inhibitors showed high adherence at 2 years with no significant differences in clinical outcomes between dapagliflozin and empagliflozin.
Absolute Event Rate: 0% vs 0%
Abstract Background Current ESC guidelines for management of HF recommend broad use of SGLT2i with class IA recommendation. Implementing other therapies into practice might be difficult due to slow up-titration rate. Unique dose of SGLT2i might allow an easier use in HFrEF patients. Purpose To present a 24 months follow-up of a cohort of HFrEF patients admitted for decompensation, in an University hospital from EU, after introduction of full reimbursement for SGLT2i treatment in HF. Method We performed a retrospective analysis from the medical notes of patients admitted with decompensated HFrEF in our department, in the first 6 months of 2023, and in whom SGLT2i were prescribed. We conducted follow-up visits at 1 and 2 years, using telephone interviews with patients or families. Dapagliflozin and empagliflozin were both available. SGLT2i were used as clinically indicated by the treating physicians. Results 289 patients with diagnosis of HFrEF and exposure to SGLT2i were assessed while being admitted in hospital for decompensation; median age was 64.9±12.8 years, 211 being males (73%). Mean hospitalization time was 8.3±6.4 days. Median NYHA class at discharge was 2, while median LVEF was 33.1±11.4%. Among treated patients, 202 (69.9%) were exposed to dapagliflozin (D), and 87 (30.1%) to empagliflozin (E). Mortality rate at discharge was 2.1%, with increase at 1 year to 13.2%, and a further increase at 2 years to 17.7%. Declared adherence to SGLT2i was 98.3% at 2 years follow-up (234/238 survivors). No significant difference in mortality between exposure to D vs. E at discharge, and during 1 and 2 years follow-up was noted. Similarly, no significant difference in re-hospitalization rate between exposure to D vs. E at 1 and 2 years follow-up was noted (at 2 years: 4.6% vs 0%). Use of both ARNI + SGLT2i at discharge was found in 23.9% of patients, while at 2 years it increased to 41.9%. Conclusions SGLT2i therapy in decompensated HFrEF is well tolerated, with good adherence at 2 years follow-up. Dapagliflozin is used in more than 2/3 of patients, but mortality and re-hospitalization rates din not differ between D and E, overall rates being low.
Vintila et al. (Sat,) reported a other. SGLT2i showed 98.3% adherence and low mortality (17.7%) at 2 years in decompensated HFrEF; no mortality difference between dapagliflozin and empagliflozin.