SGLT2 inhibitor use was associated with a lower risk of the composite cardio-vasculo-renal endpoint compared with no treatment (adjusted HR 0.70; 95% CI 0.50-0.98).
Cohort (n=240)
No
Does SGLT2 inhibitor treatment reduce the composite of cardiovascular death, HF hospitalization, or ≥40% sustained decline in eGFR/initiation of KRT in adults with chronic heart failure and LVEF ≤ 45%?
In a real-world, lower-resource setting, SGLT2 inhibitor use in patients with chronic heart failure (LVEF ≤ 45%) was associated with a 30% reduction in adverse cardio-renal events.
Effect estimate: adjusted HR 0.70 (95% CI 0.50-0.98)
Background and Objectives: Heart failure frequently coexists with CKD, compounding prognosis via cardio-renal interplay. Sodium glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular and renal benefits in randomized trials, but data remain limited in real-world lower-resource settings. Materials and Methods: We conducted a retrospective single-center cohort study at a tertiary university hospital in western Romania, including adults with chronic HF and LVEF ≤ 45%, monitored between 2021–2024. Patients were stratified based on receipt of SGLT2 inhibitors. The primary endpoint was a composite of cardiovascular death, HF hospitalization, or ≥40% sustained decline in eGFR/initiation of KRT. Annual eGFR slope was analyzed to assess renal trajectory. Results: Among 240 patients, treatment with SGLT2 inhibitors was associated with a lower risk of the composite cardio-vasculo-renal endpoint compared with no treatment (adjusted HR 0.70, 95% CI 0.50–0.98). The reduction was primarily driven by fewer heart failure hospitalizations. Decline in kidney function was slower among SGLT2 inhibitor-treated patients in longitudinal mixed-effects analyses. Conclusions: In this retrospective cohort, SGLT2 inhibitor use was associated with fewer cardio-renal events and a slower decline in kidney function. Given the observational design and residual confounding risk, these findings should be considered hypothesis-generating but provide implementation-relevant signals supporting further prospective evaluation.
Bodea et al. (Mon,) conducted a cohort in Chronic heart failure with LVEF ≤ 45% (n=240). SGLT2 inhibitors vs. No SGLT2 inhibitor treatment was evaluated on Composite of cardiovascular death, HF hospitalization, or ≥40% sustained decline in eGFR/initiation of KRT (adjusted HR 0.70, 95% CI 0.50-0.98). SGLT2 inhibitor use was associated with a lower risk of the composite cardio-vasculo-renal endpoint compared with no treatment (adjusted HR 0.70; 95% CI 0.50-0.98).