Use of sodium–glucose cotransporter 2 inhibitor in heart failure: a real-world study

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Abstract
The aim was to determine the use of Sodium - Glucose Cotransporter-2 Inhibitors (SGLT2i) in patients with heart failure with and without diabetes mellitus in Colombia. The use of SGLT2i in patients with heart failure, followed for one year was evaluated. The patterns of use, indications, adherence and persistence of SGLT2i were analyzed. Descriptive and multivariate analyses were performed. A total of 500 patients were selected, with a mean age of 70.8 ± 12.8 years and 53.0% men; 57.2% started management with dapagliflozin. SGLT2i were most frequently used for heart failure with a reduced ejection fraction (HFrEF) and New York Heart Association classification of II or III (41.0%). The drug adherence rate was 80.9 ± 16.4%, and 71.8% of the patients reported persistent SGLT2i use for one year. Hospitalizations were less common during SGLT2i treatment than in the previous year (12.2% vs. 24.4%; p < 0.001). Having a Charlson Comorbidity Index ≥3 increased the probability of persistence of SGLT2i use at one year (Odds Ratio:4.56; 95%-Confidence Interval:1.46-14.27). SGLT2i use predominates in patients with HFrEF and in those with a high comorbidity burden. Adherence and persistence were similar to or even better than those reported in other real-world evidence studies.

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