Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

SGLT2 Inhibitors Introduction and Changes of the Other Disease Modifiers’ Drugs in Heart Failure Patients: A Single Center Real World Experience

Version 1 : Received: 14 July 2023 / Approved: 14 July 2023 / Online: 17 July 2023 (15:07:48 CEST)

A peer-reviewed article of this Preprint also exists.

Tabella, E.; Correale, M.; Alcidi, G.; Pugliese, R.; Ioannoni, S.; Romano, M.; Palmieri, G.; Di Biase, M.; Brunetti, N.D.; Iacoviello, M. Introduction of SGLT2 Inhibitors and Alterations in Other Disease-Modifying Drugs in Heart Failure Patients: A Single-Centre Real-World Experience. Clin. Pract. 2023, 13, 1015-1024. Tabella, E.; Correale, M.; Alcidi, G.; Pugliese, R.; Ioannoni, S.; Romano, M.; Palmieri, G.; Di Biase, M.; Brunetti, N.D.; Iacoviello, M. Introduction of SGLT2 Inhibitors and Alterations in Other Disease-Modifying Drugs in Heart Failure Patients: A Single-Centre Real-World Experience. Clin. Pract. 2023, 13, 1015-1024.

Abstract

Background. The type-2 sodium-glucose cotransporters inhibitors (SGLT2i) are a new relevant therapeutic option for patients affected by chronic heart failure with reduced ejection fraction (HFrEF). The aim of this study was to evaluate, in a real-world population from a single center, the feasibility of introducing SGLT2i and their interaction with other recommended drug classes. Methods. We evaluated the consecutive patients affected by chronic heart failure (CHF) since January 2022. At baseline clinical visit the therapy taken by the patients as well as that prescribed were accurately collected. During a 6-12 month follow-up the the changes in concomitant therapy were analyzed. Results. At baseline, among 350 patients evaluated, only 17 (5%) were already taking SGLT2i, 13 with HFrEF, 2 with CHF with mild reduced (HFmrEF) and 2 with preserved ejection fraction (HFpEF). After baseline evaluation, SGLT2i were prescribed to 220 (63%) of all the patients enrolled, among whom 178 (84%) of HFrEF patients, 25 (42%) of HFmrEF and 17 (22%) of HFpEF. After follow-up, SGLT2i therapy was highly tolerated and it was associated with a significant increased prescription of sacubitril/valsartan and a reduced use of diuretics. Finally, a significant improvement in functional status and left ventricular systolic function after SGLT2i therapy was observed. Conclusions. In this single center “real world” study, SGLT2i were prescribed in HFrEF patients most of all already in therapy with the other classes of drugs currently recommended for their treatment. Moreover, a further optimization in prescribed ther-apy was observed during a short term follow-up. These data further support the use of this thera-peutic approach in routine clinical practice.

Keywords

Heart Failure; Therapy; type-2 sodium-glucose cotransporters inhibitors; angiotensin receptor neprylisin inhibitors

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

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