학술논문

Prognosis of patients eligible for dapagliflozin in acute heart failure.
Document Type
Article
Source
European Journal of Clinical Investigation. Jun2020, Vol. 50 Issue 6, p1-8. 8p.
Subject
*SODIUM-glucose cotransporter 2 inhibitors
*HEART failure
*PATIENT readmissions
Language
ISSN
0014-2972
Abstract
Background: Dapagliflozin, a sodium‐glucose cotransporter 2 inhibitor, was shown in the DAPA‐HF study to reduce the risk of worsening heart failure or death in symptomatic patients with left ejection fraction <40%, irrespective of diabetes. The aim of this study was to evaluate eligibility status for dapagliflozin in non‐selected patients hospitalized for acute decompensated heart failure (ADHF), as well as prognostic implications of this status. Materials and methods: Analysis of 815 patients recruited in a prospective cohort of acute heart failure at the University Hospitals of Geneva, consisting of consecutive patients admitted with ADHF. Eligibility for dapagliflozin was determined using criteria described DAPA‐HF. Results: Of 815 patients, 220 (27%) were eligible for dapagliflozin treatment. In survival analysis, patients who were eligible for dapagliflozin had better clinical outcomes with respect to all‐cause mortality and rehospitalization as compared to those who were not eligible. In multivariate analysis, the hazard ratio for all‐cause mortality or readmission in patients eligible for dapagliflozin was 0.82 (95% CI 0.68‐0.999, P =.049) as compared to the non‐eligible. Conclusions: Using DAPA‐HF criteria, only 27% of non‐selected patients admitted for ADHF are theoretically eligible for dapagliflozin. This eligibility for dapagliflozin is associated with better outcomes. Further evaluation of the benefits of dapagliflozin in selected HF patients may be of interest. This may have implications for selection criteria in future randomized effectiveness studies. [ABSTRACT FROM AUTHOR]