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Importance of sodium-glucose cotransporter 2 inhibitor use in diabetic patients with acute heart failure
- Source :
- Therapeutic Advances in Cardiovascular Disease, Vol 13 (2019), Therapeutic Advances in Cardiovascular Disease
- Publication Year :
- 2019
- Publisher :
- SAGE Publishing, 2019.
-
Abstract
- Background:It is known that once heart failure occurs in older patients with diabetes, the overall prognosis is extremely poor. We investigated whether early initiation of SGLT2 inhibitor therapy after admission was beneficial for diabetic patients requiring inpatient treatment for acute heart failure.Methods:We retrospectively assessed consecutive patients with comorbid diabetes who were admitted to the Department of Cardiology in Tosei General Hospital for treatment of acute heart failure. Patients were divided into two groups: those who initiated SGLT2 inhibitor therapy (SGLT2 inhibitor group; mean age: 73 ± 9 years) and those who did not receive the inhibitors during hospitalization (conventional treatment group; mean age: 75 ± 10 years).Results:No intergroup differences were observed in the distribution of either the severity or classes of heart failure on admission. Glycosylated hemoglobin levels were significantly higher in the SGLT2 inhibitor group (HbA1c: 8.1% ± 0.8%) than in the conventional treatment group (HbA1c: 7.1% ± 0.8%) ( p = 0.003). After admission, patients in both groups recovered equally well, and in almost the same period of time, before discharge. The rate of diuretics use at the time of discharge in the SGLT2 inhibitor group ( n = 8, 67%) was significantly lower than that in the conventional treatment group ( n = 19, 100%) ( p = 0.016). In particular, the dose of loop diuretics in the conventional treatment group was 34 ± 4 mg/day while that in the SGLT2 inhibitor group was significantly lower at 13 ± 5 mg/day ( p = 0.008). During hospitalization, the incidence of acute kidney injury was significantly higher in the conventional treatment group ( n = 11, 58%) than in the SGLT2 inhibitor group ( n = 2, 16%) ( p = 0.031).Conclusions:For the treatment and management of heart failure in patients with diabetes, early initiation of SGLT2 inhibitor therapy appears to be effective.
- Subjects :
- Blood Glucose
Male
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
heart failure
Comorbidity
030204 cardiovascular system & hematology
Gastroenterology
Early initiation
03 medical and health sciences
0302 clinical medicine
Patient Admission
Older patients
Japan
Sodium Potassium Chloride Symporter Inhibitors
Risk Factors
Diabetes mellitus
Internal medicine
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Sodium-Glucose Cotransporter 2 Inhibitor
Sodium-Glucose Transporter 2 Inhibitors
Aged
Retrospective Studies
Original Research
Extremely Poor
Aged, 80 and over
Glycated Hemoglobin
business.industry
Acute kidney injury
SGLT2 inhibitor
Recovery of Function
Acute Kidney Injury
Middle Aged
medicine.disease
Progression-Free Survival
Diabetes Mellitus, Type 2
lcsh:RC666-701
Heart failure
Acute Disease
diabetes mellitus
Female
SGLT2 Inhibitor
Cardiology and Cardiovascular Medicine
business
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 17539455
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Therapeutic Advances in Cardiovascular Disease
- Accession number :
- edsair.doi.dedup.....5ad69e15caf984c5b658dffdfa977067