Key result
SGLT2i use lags behind traditional heart failure therapies, particularly in HFpEF.
Why the study?
Significant progress has been made in the treatment of HFmrEF and HFpEF, prompting an evaluation of their real-world management within the PONTE SC/SCA registry.
What is the prescription rate of guideline-directed medical therapy in patients with HFmrEF and HFpEF in a regional registry?
Observational (n=1,203)
What is the prescription rate of guideline-directed medical therapy in patients with HFmrEF and HFpEF in a regional registry?
Data from a regional registry demonstrates that while traditional heart failure therapies are widely prescribed in HFmrEF and HFpEF, the use of SGLT2 inhibitors remains limited, highlighting an area for care optimization.
Highlights SGLT2i under-prescription in HFpEF; extends real-world GDMT data but requires confirmation in larger cohorts.
Background & Study Aim In recent years, significant progress has been made not only in the treatment of heart failure with reduced ejection fraction (HFrEF) but also in patients with mildly reduced (HFmrEF) and preserved ejection fraction (HFpEF). This study aimed to evaluate the management of HFmrEF and HFpEF patients within the PONTE SC/SCA registry. Methods and Results Between January 2024 and September 2025, 1,203 patients were enrolled, including 189 with HFmrEF and 302 with HFpEF. Prescribed pharmacological therapy was analyzed, focusing on angiotensin–converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), angiotensin receptor–neprilysin inhibitors (ARNI), beta–blockers, mineralocorticoid receptor antagonists (MRA), and sodium–glucose co–transporter 2 inhibitors (SGLT2i). As shown in the figure, ACEi/ARB/ARNI, beta–blockers, and MRA were prescribed in a high proportion of cases, whereas SGLT2i use was more limited, particularly among HFpEF patients. Conclusions The PONTE SC/SCA registry demonstrates partial optimization of therapy in HFmrEF and HFpEF patients, especially regarding SGLT2i use. These findings provide valuable insights for further improving diagnostic and therapeutic pathways in heart failure and highlight the importance of a regional registry as a tool for monitoring and optimizing patient care.
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Palmieri et al. (2026) conducted an observational in Heart failure with mildly reduced (HFmrEF) and preserved ejection fraction (HFpEF) (n=1,203). Pharmacological therapy (ACEi, ARB, ARNI, beta-blockers, MRA, SGLT2i) was evaluated on Prescribed pharmacological therapy. In a regional registry of 1,203 heart failure patients, ACEi/ARB/ARNI, beta-blockers, and MRA were frequently prescribed, whereas SGLT2i use was more limited, particularly in HFpEF.
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