The incidence and prevalence of heart failure (HF) has increased in recent years. Experts suggest that this increase in frequency may be due to the growing elderly population with comorbidities such as hypertension and T2DM. Another reason why the number of HF patients has risen could be due to longer survival in those individuals with the condition. HF is a leading cause of hospitalizations, and recurrent HF hospitalization (hFH) predicts cardiovascular (CV) and all-cause mortality. 

In a recent meta-analysis, investigators mined data from various trials, which are grouped by HF presentation as follows:

•Patients with HF with mid-range ejection fraction (HFmrEF) or HF with preserved ejection fraction (HFpEF)

-DELIVER trial (dapagliflozin)

-EMPEROR-Preserved trial (empagliflozin)

•Patients with HF with reduced ejection fraction (HFrEF)

-DAPA-HF trial (dapagliflozin)

-EMPEROR-Reduced trial (empagliflozin)

•Patients with worsening HF regardless of ejection fraction

-SOLOIST-WHF trial (sotagliflozin)

The aim of this meta-analysis was to gauge the effects of SGLT2 inhibitors on different clinical outcomes of heart failure. 

In the trials assessed (n=21,947), SGLT2 inhibitors decreased the risk of composite cardiovascular death or hospitalization for heart failure (HR: 0.77); cardiovascular death (HR: 0.87); first hospitalization for heart failure (HR: 0.72); and all-cause mortality (HR: 0.92) Overall, this meta-analysis demonstrated that SGLT2 inhibitors decreased the risk of cardiovascular death and hospitalizations for heart failure in a broad gamut of heart-failure presentations, thus bolstering their role as foundational therapy for heart failure—regardless of ejection fraction.

What have you found to be effective in reducing the risk of heart-failure hospitalization in your HF patients?