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Long-term efficacy of SGLT2 inhibitors for elderly patients with acute decompensated heart failure: The OASIS-HF

Michitaka Amioka1,2, Hiroki Kinoshita3, Yuto Fuji2

  • 1Deparment of Cardiovascular Medicine, Shininokuchi Medical Clinic, Hiroshima, Japan.

ESC Heart Failure
|September 28, 2024
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) significantly reduce heart failure (HF) rehospitalization and cardiovascular death in elderly patients. SGLT2i also protect kidney function and decrease long-term repeated HF hospitalizations.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are established cardioprotective agents, reducing cardiovascular death and heart failure (HF) hospitalizations.
  • Limited data exist on the impact of SGLT2i on preventing rehospitalization after an initial HF event.

Purpose of the Study:

  • To investigate the effect of SGLT2i on rehospitalization rates and cardiovascular death in elderly patients hospitalized for acute decompensated HF.
  • To assess the impact of SGLT2i on renal function, specifically the estimated glomerular filtration rate (eGFR) slope.

Main Methods:

  • A multicentre, prospective observational cohort study (OASIS-HF) enrolled 361 patients aged ≥75 years hospitalized for acute decompensated HF.
  • Patients were divided into two groups: conventional medical therapy and SGLT2i.
  • Outcomes evaluated included composite events of HF rehospitalization or cardiovascular death, annual rehospitalization rates, and the change in eGFR slope at 1 year.

Main Results:

  • Over a mean follow-up of 24.9 months, SGLT2i use was associated with a lower incidence of composite events (35.4% vs. 22.1%, P=0.016).
  • The average annual HF rehospitalization rate was significantly lower in the SGLT2i group (0.14 vs. 0.22, P=0.019).
  • The decline in eGFR over 1 year was significantly slower in the SGLT2i group (-3.55 mL/min/1.73 m² vs. -1.42 mL/min/1.73 m², P=0.025).

Conclusions:

  • SGLT2 inhibitors reduce the composite risk of HF rehospitalization or cardiovascular death in elderly patients.
  • SGLT2i treatment is associated with a significant decrease in long-term repeated HF hospitalizations.
  • SGLT2 inhibitors also demonstrate a protective effect against worsening renal function in this patient population.
Abstract

Keywords:
Cardiovascular deathEjection fractionHeart failureRehospitalizationSodium‐glucose cotransporter 2 inhibitors

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