Use of SGLT2i and ARNi in patients with atrial fibrillation and heart failure in 2021-2022: an analysis of real-world data.
Use of SGLT2i and ARNi in patients with atrial fibrillation and heart failure in 2021-2022: an analysis of real-world data.
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2021-2022 年 SGLT2i 和 ARNi 在心房颤动和心力衰竭患者中的使用：真实世界数据分析。
DOI：
10.1101/2023.09.08.23295280
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Lutsey,PamelaL
中科院分区：
文献类型：
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作者：
Alonso,Alvaro;Morris,AlannaA;Naimi,AshleyI;Alam,AniqaB;Li,Linzi;Subramanya,Vinita;Chen,LinYee;Lutsey,PamelaL
目的评价钠-葡萄糖协同转运蛋白-2抑制剂（SGLT 2 i）和血管紧张素受体脑啡肽酶抑制剂（ARNi）在房颤（AF）和心力衰竭（HF）患者中的应用。使用经验证的算法识别AF和HF患者，并将患者分类为射血分数降低（HFrEF）或射血分数保留（HFpEF）的HF患者。我们评估了总体和HF类型的SGLT 2 i和ARNi使用率。此外，我们探讨了相关的低利用率，包括人口统计学和comorbidity.ResultsThe研究人群包括60,927例（平均年龄75岁，43%的女性）诊断为AF和HF（85%与HFpEF，15%与HFrEF）。ARNi使用率总体为11%（HFrEF为30%，HFpEF为8%），而SGLT 2 i的相应数字为6%（HFrEF为13%，HFpEF为5%）。在研究期间，两种药物的使用均增加：ARNi从9%增加至12%（HFrEF从22%增加至29%，HFpEF从6%增加至8%），SGLT 2 i从3%增加至9%（HFrEF从6%增加至16%，HFpEF从2%增加至7%）。女性性别，年龄较大，和特定的合并症与这两种药物类型的整体和HF type.ConclusionUse的ARNi和SGLT 2 i在AF和HF患者中的利用率较低相关，特别是在女性和老年人中，虽然利用率正在增加。这些结果强调需要了解这些差异的原因，并制定干预措施，以改善AF和HF共病患者的循证治疗。
ObjectiveTo evaluate utilization of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and angiotensin receptor neprilysin inhibitors (ARNi) in patients with atrial fibrillation (AF) and heart failure (HF).MethodsWe analyzed the MarketScan databases for the period 1/1/2021 to 6/30/2022. Validated algorithms were used to identify patients with AF and HF, and to classify patients into HF with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). We assessed the prevalence of SGLT2i and ARNi use overall and by HF type. Additionally, we explored correlates of lower utilization, including demographics and comorbidities.ResultsThe study population included 60,927 patients (mean age 75, 43% female) diagnosed with AF and HF (85% with HFpEF, 15% with HFrEF). Prevalence of ARNi use was 11% overall (30% in HFrEF, 8% in HFpEF), while the corresponding figure was 6% for SGLT2i (13% in HFrEF, 5% in HFpEF). Use of both medications increased over the study period: ARNi from 9% to 12% (from 22% to 29% in HFrEF, from 6% to 8% in HFpEF), and SGLT2i from 3% to 9% (from 6% to 16% in HFrEF, from 2% to 7% in HFpEF). Female sex, older age, and specific comorbidities were associated with lower utilization of these two medication types overall and by HF type.ConclusionUse of ARNi and SGLT2i in patients with AF and HF is suboptimal, particularly among females and older individuals, though utilization is increasing. These results underscore the need for understanding reasons for these disparities and developing interventions to improve adoption of evidence-based therapies among patients with comorbid AF and HF.