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Safety and Efficacy of Dapagliflozin in Patients with Heart Failure with Reduced Ejection Fraction: Multicentre Retrospective Study on Echocardiographic Parameters and Biomarkers of Heart Congestion.
Battistoni, Ilaria; Pongetti, Giulia; Falchetti, Elena; Giannini, Irene; Olivieri, Roberto; Gioacchini, Filippo; Bonelli, Paolo; Contadini, Daniele; Scappini, Lorena; Flori, Marco; Giovagnoli, Andrea; De Maria, Renata; Marini, Marco.
Afiliação
  • Battistoni I; Department of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti, 60100 Ancona, Italy.
  • Pongetti G; Department of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti, 60100 Ancona, Italy.
  • Falchetti E; Cardiology Department, Senigallia Hospital, 60019 Senigallia, Italy.
  • Giannini I; Department of Cardiology, Camerino-Hospital, 62032 Camerino, Italy.
  • Olivieri R; Cardiology Unit, Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy.
  • Gioacchini F; O.U. of Cardiology, Ospedale Civile A. Murri, 63900 Fermo, Italy.
  • Bonelli P; Department of Cardiology, Cardiac Intensive Care Unit, Centre of Telemedicine, Italian National Research Centre on Aging (INRCA), 60127 Ancona, Italy.
  • Contadini D; Cardiology Division, Ospedale Provinciale AREA VASTA 3, 62100 Piediripa, Italy.
  • Scappini L; Cardiology Unit, Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy.
  • Flori M; U.O.C. Cardiology-Utic Ospedale della Misericordia Urbino AST Pesaro-Urbino, 61029 Urbino, Italy.
  • Giovagnoli A; Cardiology Unit, Carlo Urbani Hospital, 60035 Jesi, Italy.
  • De Maria R; Istituto di Fisiologia Clinica CNR Pisa, 56124 Pisa, Italy.
  • Marini M; Department of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti, 60100 Ancona, Italy.
J Clin Med ; 13(12)2024 Jun 16.
Article em En | MEDLINE | ID: mdl-38930049
ABSTRACT

Objectives:

Dapagliflozin has shown efficacy in clinical trials in patients with heart failure and reduced ejection fraction (HFrEF). However, real-world data on its use and outcomes in routine clinical practice are limited. We aimed to evaluate the utilisation and safety profile of dapagliflozin in a real-world population of HFrEF patients within the Marche region.

Methods:

Nine cardiology departments within the Marche region retrospectively included HFrEF patients who were initiated on dapagliflozin therapy in an outpatient setting. Data on medical history, comorbidities, echocardiographic parameters, and laboratory tests were collected at baseline and after 6 months. Telephone follow-up interviews were conducted at 1 and 3 months to assess adverse events. We defined the composite endpoint score as meeting at least 50% of four objective measures of improvement among weight loss, NYHA decrease, ≥50% Natriuretic peptides (NP) decrease, and guideline/directed medical therapy (GDMT) up titration.

Results:

We included 95 HFrEF patients aged 66 ± 12 years, 82% were men, 48% had ischemic heart disease, and 20% had diabetes. At six months, glomerular filtration rate declined (p = 0.03) and natriuretic peptides levels decreased, on average, by 23% (p < 0.001). Echocardiographic measurements revealed a decrease in pulmonary artery pressure (p < 0.001) and E/e' (p < 0.001). In terms of drug therapy, furosemide dosage decreased (p = 0.001), and the percentage of the target dose achieved for angiotensin receptor-neprilysin inhibitors increased (p = 0.003). By multivariable Cox regression, after adjustment for age, sex, the presence of diabetes/prediabetes, and HF duration, higher baseline Hb concentrations (HR 1.347, 95% CI 1.038-1.746, p = 0.025), and eGFR levels (HR 1.016, 95% CI 1.000-1.033, p = 0.46).

Conclusions:

In a real-life HFrEF population, dapagliflozin therapy is safe and well-tolerated, improves echocardiographic parameters and biomarkers of congestion, and can also facilitate the titration of drugs with a prognostic impact.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Clin Med Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Clin Med Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Itália