Heart failure & cardiomyopathies
Cardio–Renal–Metabolic Syndrome: Clinical Features and Dapagliflozin Eligibility in a Real-World Heart Failure Cohort
Authors' conclusion
This study identified high residual risk for all-cause mortality and hospital readmission in real-world HF patients with LVEF < 50% despite GDMT. T2D and CKD aggravated the risk for these endpoints, indicating the intertwinement of HF with CKD and T2D.
Study context
- Population
- Real-world patients with heart failure (HF) and left ventricular ejection fraction (LVEF) < 50%, diagnosed 2014–2018
- Participants
- 1,333 patients
- Exposure
- HFrEF vs HFmrEF; T2D and chronic kidney disease (CKD) vs none
- HFrEFn = 920
- HFmrEFn = 413reference
- Outcome
- Composite of:
- HF readmission and mortality
- Impact of T2D
- CKD on all-cause mortality
- Follow-up
- 1 and 2 year
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Hazard ratio
1.49
P < 0.01
T2D
Hazard ratio
2.05
P < 0.001
CKD
- Composite HF readmission and mortality event rates (/100 patient years)
- 13.7 and 8.4
Observational data: associations, not effects.
Further findings
Baseline characteristics, HFrEF vs HFmrEF
CAD HFrEF 67% · HFmrEF 59%
SBP mean (SD) HFrEF 123 (22.6) mmHg · HFmrEF 133 (24.0) mmHg
NT-proBNP HFrEF 2720 pg/mL · HFmrEF 1920 pg/mL
eGFR mean (SD) HFrEF 51.4 (23.3) mL/min/1.73 m² · HFmrEF 54.1 (22.3) mL/min/1.73 m²
- Baseline characteristics, HFrEF vs HFmrEF: all differences P < 0.05
Eligibility for SGLT2i (European label)
- Dapagliflozin eligibility
- 86.5% (n = 1153)
- Empagliflozin eligibility
- 97.9% (n = 1305)
Baseline characteristics, HFrEF vs HFmrEF
- No differences in T2D and CKD
Original publication
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