In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure With Reduced Ejection Fraction

被引：69

作者：

Rao, Vishal N. ^{[1
,2
]}

Murray, Evan ^{[3
]}

Butler, Javed ^{[4
]}

Cooper, Lauren B. ^{[5
]}

Cox, Zachary L. ^{[6
]}

Fiuzat, Mona ^{[2
,3
]}

Green, Jennifer B. ^{[2
,7
]}

Lindenfeld, JoAnn ^{[8
]}

McGuire, Darren K. ^{[9
,10
]}

Nassif, Michael E. ^{[11
]}

Brien, Cara ^{[12
]}

Pagidipati, Neha ^{[1
,2
]}

Sharma, Kavita ^{[13
]}

Vaduganathan, Muthiah ^{[14
]}

Vardeny, Orly ^{[15
,16
]}

Fonarow, Gregg C. ^{[17
]}

Mentz, Robert J. ^{[1
,2
]}

Greene, Stephen J. ^{[1
,2
]}

机构：

[1] Duke Univ, Sch Med, Div Cardiol, Durham, NC USA

[2] Duke Clin Res Inst, 300 West Morgan St, Durham, NC 27701 USA

[3] Duke Univ, Sch Med, Durham, NC USA

[4] Univ Mississippi, Department Med, Jackson, MS 39216 USA

[5] North Shore Univ Hosp, Dept Cardiol, Manhasset, NY USA

[6] Vanderbilt Univ, Med Ctr, Dept Pharm, Nashville, TN USA

[7] Duke Univ, Sch Med, Div Endocrinol, Durham, NC USA

[8] Vanderbilt Univ, Med Ctr, Div Cardiovasc Med, Nashville, TN USA

[9] Univ Texas Southwestern Med Ctr Dallas, Div Cardiol, Dallas, TX 75390 USA

[10] Parkland Hlth & Hosp Syst, Dallas, TX USA

[11] Univ Missouri Kansas City, St Lukes Mid Amer Heart Inst, Kansas City, MO USA

[12] Duke Univ, Sch Med, Dept Med, Durham, NC 27706 USA

[13] Johns Hopkins Sch Med, Div Cardiol, Baltimore, MD USA

[14] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA 02115 USA

[15] Minneapolis VA Hlth Care Syst, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA

[16] Univ Minnesota, Minneapolis, MN USA

[17] Univ Calif Los Angeles, Ahmanson UCLA Cardiomyopathy Ctr, Los Angeles, CA USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2021年 / 78卷 / 20期

基金：

美国国家卫生研究院;

关键词：

  guideline-directed medical therapy; heart failure; in-hospital prescribing; medical therapy; sodium-glucose cotransporter-2 inhibitors; THERAPY; MANAGEMENT; HF; PREDISCHARGE; OUTCOMES;

D O I：

10.1016/j.jacc.2021.08.064

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Sodium-glucose cotransporter-2 inhibitor therapy is well suited for initiation during the heart failure hospitalization, owing to clinical benefits that accrue rapidly within days to weeks, a strong safety and tolerability profile, minimal to no effects on blood pressure, and no excess risk of adverse kidney events. There is no evidence to suggest that deferring initiation to the outpatient setting accomplishes anything beneficial. Instead, there is compelling evidence that deferring in-hospital initiation exposes patients to excess risk of early postdischarge clinical worsening and death. Lessons from other heart failure with reduced ejection fraction therapies highlight that deferring initiation of guideline-recommended medications to the U.S. outpatient setting carries a >75% chance they will not be initiated within the next year. Recognizing that 1 in 4 patients hospitalized for worsening heart failure die or are readmitted within 30 days, clinicians should embrace the in-hospital period as an optimal time to initiate sodium-glucose cotransporter-2 inhibitor therapy and treat this population with the urgency it deserves. (J Am Coll Cardiol 2021;78:2004-2012) (c) 2021 by the American College of Cardiology Foundation.

引用

页码：2004 / 2012

页数：9

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