Combined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction

Combined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction

Abstract Angiotensin receptor-neprilysin inhibitor (ARNI) and sodium–glucose co-transporter-2 inhibitor (SGLT2i) have shown benefits in diabetic patients with heart failure with reduced ejection fraction (HFrEF). However, their combined effect has not been revealed. We retrospectively identified dia...

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Autores principales: Hyue Mee Kim, In-Chang Hwang, Wonsuk Choi, Yeonyee E. Yoon, Goo-Yeong Cho
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Lenguaje:EN
Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/d10ce0ec93124a50a5d63f4f2bb7bdbe
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spelling oai:doaj.org-article:d10ce0ec93124a50a5d63f4f2bb7bdbe2021-11-21T12:17:39ZCombined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction10.1038/s41598-021-01759-52045-2322https://doaj.org/article/d10ce0ec93124a50a5d63f4f2bb7bdbe2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01759-5https://doaj.org/toc/2045-2322Abstract Angiotensin receptor-neprilysin inhibitor (ARNI) and sodium–glucose co-transporter-2 inhibitor (SGLT2i) have shown benefits in diabetic patients with heart failure with reduced ejection fraction (HFrEF). However, their combined effect has not been revealed. We retrospectively identified diabetic patients with HFrEF who were prescribed an ARNI and/or SGLT2i. The patients were divided into groups treated with both ARNI and SGLT2i (group 1), ARNI but not SGLT2i (group 2), SGLT2i but not ARNI (group 3), and neither ARNI nor SGLT2i (group 4). After propensity score-matching, the occurrence of hospitalization for heart failure (HHF), cardiovascular mortality, and changes in echocardiographic parameters were analyzed. Of the 206 matched patients, 92 (44.7%) had to undergo HHF and 43 (20.9%) died of cardiovascular causes during a median 27.6 months of follow-up. Patients in group 1 exhibited a lower risk of HHF and cardiovascular mortality compared to those in the other groups. Improvements in the left ventricular ejection fraction and E/e′ were more pronounced in group 1 than in groups 2, 3 and 4. These echocardiographic improvements were more prominent after the initiation of ARNI, compare to the initiation of SGLT2i. In diabetic patients with HFrEF, combination of ARNI and SGT2i showed significant improvement in cardiac function and prognosis. ARNI-SGLT2i combination therapy may improve the clinical course of HFrEF in diabetic patients.Hyue Mee KimIn-Chang HwangWonsuk ChoiYeonyee E. YoonGoo-Yeong ChoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Hyue Mee Kim
In-Chang Hwang
Wonsuk Choi
Yeonyee E. Yoon
Goo-Yeong Cho
Combined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction
description Abstract Angiotensin receptor-neprilysin inhibitor (ARNI) and sodium–glucose co-transporter-2 inhibitor (SGLT2i) have shown benefits in diabetic patients with heart failure with reduced ejection fraction (HFrEF). However, their combined effect has not been revealed. We retrospectively identified diabetic patients with HFrEF who were prescribed an ARNI and/or SGLT2i. The patients were divided into groups treated with both ARNI and SGLT2i (group 1), ARNI but not SGLT2i (group 2), SGLT2i but not ARNI (group 3), and neither ARNI nor SGLT2i (group 4). After propensity score-matching, the occurrence of hospitalization for heart failure (HHF), cardiovascular mortality, and changes in echocardiographic parameters were analyzed. Of the 206 matched patients, 92 (44.7%) had to undergo HHF and 43 (20.9%) died of cardiovascular causes during a median 27.6 months of follow-up. Patients in group 1 exhibited a lower risk of HHF and cardiovascular mortality compared to those in the other groups. Improvements in the left ventricular ejection fraction and E/e′ were more pronounced in group 1 than in groups 2, 3 and 4. These echocardiographic improvements were more prominent after the initiation of ARNI, compare to the initiation of SGLT2i. In diabetic patients with HFrEF, combination of ARNI and SGT2i showed significant improvement in cardiac function and prognosis. ARNI-SGLT2i combination therapy may improve the clinical course of HFrEF in diabetic patients.
format article
author Hyue Mee Kim
In-Chang Hwang
Wonsuk Choi
Yeonyee E. Yoon
Goo-Yeong Cho
author_facet Hyue Mee Kim
In-Chang Hwang
Wonsuk Choi
Yeonyee E. Yoon
Goo-Yeong Cho
author_sort Hyue Mee Kim
title Combined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction
title_short Combined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction
title_full Combined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction
title_fullStr Combined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction
title_full_unstemmed Combined effects of ARNI and SGLT2 inhibitors in diabetic patients with heart failure with reduced ejection fraction
title_sort combined effects of arni and sglt2 inhibitors in diabetic patients with heart failure with reduced ejection fraction
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/d10ce0ec93124a50a5d63f4f2bb7bdbe
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AT wonsukchoi combinedeffectsofarniandsglt2inhibitorsindiabeticpatientswithheartfailurewithreducedejectionfraction
AT yeonyeeeyoon combinedeffectsofarniandsglt2inhibitorsindiabeticpatientswithheartfailurewithreducedejectionfraction
AT gooyeongcho combinedeffectsofarniandsglt2inhibitorsindiabeticpatientswithheartfailurewithreducedejectionfraction
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