Use of Sodium-Glucose Cotransporter-2 Inhibitors and Angiotensin Receptor-Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real-World Data

被引:0
|
作者
Alonso, Alvaro [1 ,2 ]
Morris, Alanna A. [3 ]
Naimi, Ashley I. [2 ]
Alam, Aniqa B. [2 ]
Li, Linzi [2 ]
Subramanya, Vinita [2 ]
Chen, Lin Yee [4 ,5 ]
Lutsey, Pamela L. [6 ]
机构
[1] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, 1518 Clifton Rd NE, Atlanta, GA 30322 USA
[2] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA USA
[3] Emory Univ, Sch Med, Dept Med, Atlanta, GA USA
[4] Univ Minnesota, Lillete Heart Inst, Sch Med, Minneapolis, MN USA
[5] Univ Minnesota, Dept Med, Sch Med, Minneapolis, MN USA
[6] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA
来源
JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2024年 / 13卷 / 06期
基金
美国国家卫生研究院;
关键词
angiotensin receptor-neprilysin inhibitors; atrial fibrillation; heart failure; sodium-glucose cotransporter-2 inhibitors; VALIDATED METHODS; MULTIMORBIDITY;
D O I
10.1161/JAHA.123.032783
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: Contemporary use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and angiotensin receptor-neprilysin inhibitors (ARNi) in patients with atrial fibrillation (AF) and heart failure (HF) has not been described. METHODS AND RESULTS: We analyzed the MarketScan databases for the period January 1, 2021 to July 30, 2022. Validated algorithms were used to identify patients with AF and HF, and to classify patients into HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF). We assessed the prevalence of SGLT2i and ARNi use overall and by HF type. Additionally, we explored correlates of lower use, including demographics and comorbidities. The study population included 60 927 patients (mean age, 75 years; 43% women) diagnosed with AF and HF (85% with HFpEF, 15% with HFrEF). Prevalence of ARNi use was 11% overall (30% in HFrEF, 8% in HFpEF), whereas the corresponding figure was 6% for SGLT2i (13% in HFrEF, 5% in HFpEF). Use of both medications increased over the study period: ARNi from 9% to 12% (22%-29% in HFrEF, 6%- 8% in HFpEF), and SGLT2i from 3% to 9% (6%-16% in HFrEF, 2%-7% in HFpEF). Female sex, older age, and specific comorbidities were associated with lower use of these 2 medication types overall and by HF type. CONCLUSIONS: Use of ARNi and SGLT2i in patients with AF and HF is suboptimal, particularly among women and older individuals, though use is increasing. These results underscore the need for understanding reasons for these disparities and developing interventions to improve adoption of evidence-based therapies among patients with comorbid AF and HF.
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页数:9
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