USE OF SGLT2-i IN ELDERLY PATIENTS WITH HFrEF- REAL WORD DATA

Abstract

Abstract Introduction SGLT2-i have been shown to improve prognosis in patients with reduced ejection fraction heart failure (HFrEF) in randomized clinical trials (RCTs). However, we have little data on the use of these drugs in clinical practice, both in terms of safety and efficacy profile, especially in elderly patients. Objectives To describe the characteristics of HFrEF outpatients who started SGLT2-I and evaluate tolerability and effect of therapy. Results We evaluated 42 patients, 32 M and 10 F, with a mean age of 78±8.2 years (62.1% over 75). At baseline, the mean EF was 34.5%± 6.0 and the patients' renal function calculated with CKD-EPI was 56.3±18.6 ml/min/m2. We followed at 6 months 36 patients. After 6 months of SGLT2i therapy, there was a significant reduction in NYHA class (NYHA I 30.6% vs 9.8%, NYHA III 13.9% vs 31.7%), a slight recovery in EF (38% vs 33% p-value = 0.039) and a decrease in diuretic dose (34 mg/day vs 64 mg/day, p-value 0.033). Despite a slight initial reduction in eGFR, like RCTs, there was recovery of renal function at 6 months. At 6 months, only 2 patients discontinued SGLT2i therapy due to urinary infection. Conclusions In our analysis after 6 months of SGLT2-i therapy in elderly patients, there was clinical improvement as evidenced by improvement in NYHA class and reduction in diuretic therapy. SGLT2-i have been shown to be relatively safe, with no adverse effects occurring and no significant worsening of renal function.