دورية أكاديمية
Comparative analysis of the addition of empagliflozin versus doubling the furosemide dose in decompensated heart failure.
| العنوان: | Comparative analysis of the addition of empagliflozin versus doubling the furosemide dose in decompensated heart failure. |
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| المؤلفون: | Polat F; Department of Cardiology, Health Sciences University Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. drfuatpolat@gmail.com., Kaya Z; Department of Cardiology, ASV Yaşam Hospital, Antalya, Turkey., Süleymanoğlu C; Department of Cardiology, Osmaniye State Hospital, Osmaniye, Turkey. |
| المصدر: | Cardiovascular drugs and therapy [Cardiovasc Drugs Ther] 2024 Jun 12. Date of Electronic Publication: 2024 Jun 12. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Kluwer Academic For The International Society For Cardiovascular Pharmacotherapy Country of Publication: United States NLM ID: 8712220 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-7241 (Electronic) Linking ISSN: 09203206 NLM ISO Abbreviation: Cardiovasc Drugs Ther Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Norwell Ma : Kluwer Academic For The International Society For Cardiovascular Pharmacotherapy Original Publication: [Norwell, MA] : Martinus Nijhoff Pub., [c1987- |
| مستخلص: | Introduction: This study aims to compare the addition of SGLT2 inhibitors or doubling the diuretic dose in patients receiving treatment with beta-blockers, angiotensin-converting enzyme inhibitors (ACEi), or angiotensin receptor blockers (ARB), as well as mineralocorticoid receptor antagonists (MRA), for heart failure with reduced ejection fraction (HFrEF) who present to the emergency department with decompensated heart failure. Methods: This study is a single-center and prospective analysis. A total of 980 decompensated heart failure (HFrEF) patients receiving optimal medical therapy (OMT) according to the 2021 European heart failure guidelines were randomized in a 2:1 ratio into the furosemide and empagliflozin treatment arms. The analysis includes patient clinical characteristics, laboratory results, and echocardiographic data. Factors influencing rehospitalization were identified through multivariate Cox regression analysis. Log-rank analysis was employed to assess factors affecting rehospitalization. Results: The mean age of the patients was 67.9 years, with 52.1% being men. There was no significant impact of demographic, clinical, or echocardiographic factors on rehospitalization at 1 month; only the effect of treatment subgroups on rehospitalization was observed (p = 0.039). Significant echocardiographic and clinical improvements were seen in both treatment arms. The empagliflozin group exhibited significant improvements in 6-min walk distance, heart rate, body weight, NT-pro BNP levels, and eGFR level compared to the furosemide group. The rate of rehospitalization in the first month was significantly lower in those receiving empagliflozin (28.7%) compared to those receiving a double dose of furosemide (40.2%) (log-rank p = 0.013). Discussion and Conclusion: This study provides valuable insights into the management of decompensated HFrEF and demonstrates that SGLT2 inhibitors offer benefits beyond glycemic control in this patient group. The significant reduction in rehospitalization rates and improvements in echocardiographic parameters underscore the potential of SGLT2 inhibitors in reducing acute heart failure episodes. (© 2024. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Decompensated heart failure; Echocardiographic outcomes; Empagliflozin; Furosemide; Rehospitalization |
| تواريخ الأحداث: | Date Created: 20240612 Latest Revision: 20240612 |
| رمز التحديث: | 20240612 |
| DOI: | 10.1007/s10557-024-07593-x |
| PMID: | 38864970 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1573-7241 |
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| DOI: | 10.1007/s10557-024-07593-x |