Factors Associated with Recurrent Heart Failure during Incorporating SGLT2 Inhibitors in Patients Hospitalized for Acute Decompensated Heart Failure.
Factors Associated with Recurrent Heart Failure during Incorporating SGLT2 Inhibitors in Patients Hospitalized for Acute Decompensated Heart Failure.
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DOI：
10.3390/jcm11175027
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发表时间：
2022-08-26
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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作者：
背景：钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）可降低慢性心衰患者因心力衰竭（HF）住院或心血管原因死亡的风险。然而，对于急性失代偿性心力衰竭（ADHF）住院患者SGLT2i治疗期间与临床事件相关的具体因素知之甚少。方法：回顾性分析2016年2月至2021年4月期间因ADHF住院并连续接受SGLT2i治疗的患者。我们调查了SGLT2i治疗期间HF复发住院的相关因素。结果：共纳入143例患者（中位年龄73岁，男性92例）。估计肾小球滤过率（eGFR）与主要终点呈负相关，风险比为0.94（95%可信区间0.90-0.98,p = 0.007）。eGFR < 40.9 mL/min/1.73 m2的患者（n = 47）在1年治疗期间HF住院自由显著降低（73%对94%，p = 0.005）。结论：在ADHF住院期间接受SGLT2i药物治疗的患者中，基线时较低的eGFR与HF复发住院相关。强烈建议在肾功能恶化之前早期给予SGLT2i，以获得更大的SGLT2i益处。
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce the risk of hospitalization for heart failure (HF) or death from cardiovascular causes among patients with chronic HF. However, little is known about the specific factors associated with clinical events during SGLT2i therapy in patients hospitalized for acute decompensated heart failure (ADHF). Methods: Consecutive patients who were hospitalized for ADHF and received SGLT2i during the index hospitalization between February 2016 and April 2021 were retrospectively evaluated. We investigated the factors associated with recurrent hospitalization for HF during the SGLT2i therapy. Results: A total of 143 patients (median age 73 years, 92 men) were included. Estimated glomerular filtration rate (eGFR) was negatively associated with a primary endpoint with a hazard ratio of 0.94 (95% confidence interval 0.90–0.98, p = 0.007). Those with lower eGFR < 40.9 mL/min/1.73 m2 (n = 47) had significantly lower freedom from HF hospitalization during 1-year therapeutic period (73% versus 94%, p = 0.005). Conclusions: Among patients who initiated medical therapy incorporating SGLT2i during the hospitalization for ADHF, a lower eGFR at baseline was associated with a recurrent hospitalization for HF. Early administration of SGLT2i prior to deterioration of renal function would be highly recommended to enjoy greater benefit from SGLT2i.
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