| Autor: |
Lima Falcao Angelim, Sarah Correia, Tito, Sahana, Canonigo Casipit, Bruce Adrian, Cantu Martinez, Omar, Ogunmola, Isaac Omolade, Barreira Angelim, Lucas, Shah, Samir, Lo, Kevin Bryan, Rangaswami, Janani |
| Předmět: |
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| Zdroj: |
Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research); 2024, Vol. 15 Issue 7, p2205-2217, 13p |
| Abstrakt: |
Background In patients with heart failure with reduced ejection fraction (HFrEF), SGLT2 inhibitors have consistently demonstrated improved cardiovascular and renal outcomes regardless of diabetes status. However, SGLT2i remain significantly under-utilized in this patient population. We seek to study the current state of SGLT2i use and barriers to utilization using real- world data in an inner -city community hospital setting. Methods This is a single center retrospective analysis of patients diagnosed with HFrEF, defined as ejection fraction ≤ 40%, seen from December 2019 to December 2021, in the outpatient setting. Results A total of 464 patients were included in this analysis, where SGLT2 inhibitors were indicated for type 2 diabetes mellitus, chronic kidney disease (CKD), and/or heart failure. Twenty five percent of patients were on SGLT2 inhibitors, despite low frequency of absolute or relative contraindications (5%) and 14% of patients had ≥CKD4with eGFR<30ml/min/1.73m². History of CAD [OR 0.30; 95% CI 0.18-0.50; p<0.001], ≥CKD4 [OR 0.35; 95% CI 0.16-0.73; p=0.005] and higher ejection fraction on the spectrum of HFrEF [OR 0.95; 95% CI 0.92-0.97; p<0.001] were significantly inversely associated with SGLT2i use. Conclusions There was significant under-utilization of SGLT2i in this single center analysis, despite lack of absolute and relative contraindications in the majority of our study population and the presence of multiple possible indications including concomitant type 2 diabetes and CKD. More pragmatic studies are needed emphasizing practical implementation of medical management for high-risk patient populations. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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