Abstract
Retrospective national sub-analysis of antidiabetic pharmacotherapy in patients with diabetes mellitus (DM) and heart failure (HF) based on data reported to the National Register of Paid Health Services in the Czech Republic between 2012-2018. In 2012, there were 75,022 patients with HF and DM (i.e. 42.5% of patients with HF), 6 years later 117,265 (i.e. 41.0% of HF patients in 2018). The most represented antidiabetic drug was metformin (45.6%). Of the insulins and analogues, glargine showed the largest positive trend (5.8% 2012; 14.8% 2018). Empagliflozin was the most prescribed SGLT-2 inhibitor (1.8% in 2018). A decrease in prescribing was observed for saxagliptin (0.5% 2012; 0.1% 2018) and for sulfonylurea derivates - gliclazide (13.0% 2012; 10.3% in 2018) and glimepiride (12.9% 2012; 9.0% 2018). Linagliptin was the most prescribed dipeptidyl peptidase inhibitor (0.7% 2012; 6.8% 2018). In the Czech Republic, between 2012 and 2008, there was an increase in prevalence of patients with heart failure and concomitant diabetes mellitus, their proportion being similar. In correspondence with other registries, metformin was used mostly. A positive trend was observed in prescription of DDP-4 and SGLT-2 inhibitors, while there was a significant decrease in patients taking sulfonylureas.
Highlights
Heart failure (HF) and diabetes mellitus (DM) are among the major diseases of civilization
In 2012, a total of 10.52 million people lived in the Czech Republic. 176,496 persons had HF, of which 75,022 (42.5%) had both diagnoses (HF and DM)
Based on a joint consensus of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), metformin remains the drug of first choice in patients with T2DM
Summary
Heart failure (HF) and diabetes mellitus (DM) are among the major diseases of civilization. There are an estimated 64.3 million people with HF (ref.[1]). It is assumed that more than 10% of people in the population over 70 years have some form of HF. According to the most recent European Society of Cardiology (ESC) guidelines from 2016, we divide patients with HF into three subgroups according to left ventricular ejection fraction (LVEF), namely HF with reduced LVEF (HFrEF 50%) (ref.[4]). HF is a major socio-economic problem, especially in developed countries. In 2012, the cost of treatment worldwide was estimated at $ 108 billion per annum[5]
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