Among ADHF patients initiating SGLT2i therapy, baseline eGFR was negatively associated with recurrent HF hospitalization (HR 0.94; 95% CI 0.90-0.98; p=0.007).
Cohort (n=143)
What baseline factors are associated with recurrent heart failure hospitalization in patients initiated on SGLT2 inhibitors during hospitalization for acute decompensated heart failure?
In patients hospitalized for ADHF, initiating SGLT2 inhibitors earlier, prior to significant renal deterioration (eGFR < 40.9 mL/min/1.73 m2), is associated with a lower risk of recurrent heart failure hospitalization.
Hazard Ratio: 0.94 (95% CI 0.9–0.98)
Absolute Event Rate: 73% vs 94%
p-value: p=0.007
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce the risk of hospitalization for heart failure (HF) or death from cardiovascular causes among patients with chronic HF. However, little is known about the specific factors associated with clinical events during SGLT2i therapy in patients hospitalized for acute decompensated heart failure (ADHF). Methods: Consecutive patients who were hospitalized for ADHF and received SGLT2i during the index hospitalization between February 2016 and April 2021 were retrospectively evaluated. We investigated the factors associated with recurrent hospitalization for HF during the SGLT2i therapy. Results: A total of 143 patients (median age 73 years, 92 men) were included. Estimated glomerular filtration rate (eGFR) was negatively associated with a primary endpoint with a hazard ratio of 0.94 (95% confidence interval 0.90−0.98, p = 0.007). Those with lower eGFR < 40.9 mL/min/1.73 m2 (n = 47) had significantly lower freedom from HF hospitalization during 1-year therapeutic period (73% versus 94%, p = 0.005). Conclusions: Among patients who initiated medical therapy incorporating SGLT2i during the hospitalization for ADHF, a lower eGFR at baseline was associated with a recurrent hospitalization for HF. Early administration of SGLT2i prior to deterioration of renal function would be highly recommended to enjoy greater benefit from SGLT2i.
Nakagaito et al. (Fri,) conducted a cohort in Acute Decompensated Heart Failure (n=143). Lower eGFR (< 40.9 mL/min/1.73 m2) vs. Higher eGFR (≥ 40.9 mL/min/1.73 m2) was evaluated on freedom from HF hospitalization (HR 0.94, 95% CI 0.90-0.98, p=0.007). Among ADHF patients initiating SGLT2i therapy, baseline eGFR was negatively associated with recurrent HF hospitalization (HR 0.94; 95% CI 0.90-0.98; p=0.007).