Gliflozins in Practice: Real-Life Use of Dapagliflozin and Empagliflozin in HFrEF Versus Clinical Trial Data - PubMed
6 hours ago
- #heart failure
- #SGLT2 inhibitors
- #real-world data
- SGLT2 inhibitors (SGLT2is) like dapagliflozin and empagliflozin are standard therapy for heart failure (HF) patients.
- A retrospective study analyzed 370 HF patients with reduced or improved ejection fraction (HFrEF/HFimpEF) treated with dapagliflozin or empagliflozin.
- Patients on empagliflozin were older, had higher NYHA class, LVEF, and diabetes incidence, while dapagliflozin users had more sacubitril/valsartan and mineralocorticoid receptor antagonist use.
- Real-world patients were older than those in clinical trials (RCTs), with differing LVEF profiles compared to DAPA-HF and EMPEROR-Reduced trials.
- HF hospitalizations were more frequent in real-world groups, but mortality was lower than in RCTs.
- Composite outcomes (death and worsening HF) were higher in real-world dapagliflozin users vs. DAPA-HF but similar for empagliflozin users vs. EMPEROR-Reduced.
- Empagliflozin was associated with cardio-nephro-metabolic comorbidities, while dapagliflozin was prescribed more for isolated cardiac symptoms.
- Real-world outcomes differed from RCTs, emphasizing the importance of real-world data in understanding therapy applications.