Among 289 acute HF patients, only 39% received SGLT2 inhibitors and 54% adhered to therapy, highlighting underuse of guideline-directed treatments despite high comorbidity.
What are the current trends of guideline-directed medical therapy and comorbidity burden among patients hospitalized with acute heart failure decompensation in Greece?
In a Greek cross-sectional cohort of acute heart failure admissions, patients had a high comorbidity burden and significant underutilization of guideline-directed medical therapies, particularly SGLT2 inhibitors.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background/Introduction The majority of acute heart failure (HF) events resemble episodes of decompensated chronic HF; they are common cause of hospitalization among patients over the age of 65 years and are linked to significant mortality rates. Contemporary HF treatments have proven benefit in reducing readmission rates. Purpose The objective of this study is to detect the current trends of guideline directed medical therapy among Cardiology inpatients hospitalized with acute HF decompensation in Greece. Methods HECMOS 2.0 was a cross-sectional snapshot of Cardiology inpatients in Greece on June 5, 2024. Acute HF admission data were utilized for this analysis, out of 1,122 participants from 72 Cardiology clinics covering the diverse geographic and socioeconomic aspects of Greece. Results Out of 1,122 participants, 289 patients were hospitalized with an episode of acute HF decompensation (61% male, mean age 76 years). In their majority, they had low ejection fraction (48%), followed by those with preserved ejection fraction (34%), and mildly reduced ejection fraction (16%). 1.8% were classified as having pure right-sided HF. The most common triggers of HF decompensation included coexisting infection (24%), non-adherence to medication (22%), hypertensive emergencies (20%), paroxysms of atrial fibrillation with rapid ventricular response (12%), and NSAID use (0.3%). With regards to the underlying principal HF aetiology, coronary artery disease was common (41%) followed by valvular disease (24.6%), hypertensive heart disease (17%), dilated cardiomyopathy (10%), hypertrophic cardiomyopathy (3%), and infiltrative diseases (1%). 60% of cases had chronic or paroxysmal atrial fibrillation (3% had undergone AF ablation), 57% had chronic kidney disease (CKD) and 39% diabetes mellitus (DM). Regarding chronic medications, the majority of patients were on diuretics (82%), followed by beta blockers (77.5%), mineralocorticoid receptor antagonists (46%), renin-angiotensin-aldosterone system inhibitors (36%), and angiotensin receptor/neprilysin inhibitors (9%). Only 39% of patients were on SGLT2 inhibitors, and only 54% were compliant with their prescribed treatment. Conclusion Among cases hospitalized with acute HF, decompensation comorbidity burden was considerably high, whereas guideline directed medical therapy namely SGLT2i proven to reduce readmission rates, were underutilized. Better management of comorbidities and GDMT implementation together with enhanced adherence could potentially had prevented some of the recorded hospitalization events.
Manta et al. (Sat,) reported a other. Among 289 acute HF patients, only 39% received SGLT2 inhibitors and 54% adhered to therapy, highlighting underuse of guideline-directed treatments despite high comorbidity.