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. 2024 Jun 22:53:101448.
doi: 10.1016/j.ijcha.2024.101448. eCollection 2024 Aug.

Eligibility of sodium-glucose cotransporter-2 inhibitors in heart failure with preserved ejection fraction: Insights from the Colombian heart failure registry (RECOLFACA)

Juan Esteban Gómez-Mesa  1   2 , Clara Saldarriaga  3 , Alex Arnulfo Rivera-Toquica  4   5   6 , Silfredo Arrieta-González  7 , Alfonso Muñoz-Velásquez  8 , Eduardo José Echeverry-Navarrete  9 , Julián Rodrigo Lugo-Peña  10 , Juan Alberto Cerón  11 , Oscar Sveins Rincón-Peña  12 , Luis Eduardo Silva-Diazgranados  13 , Hugo Ernesto Osorio-Carmona  14 , Alejandro Posada-Bastidas  15 , Juan Camilo García  8 , Alejandro David Ochoa-Morón  16 , Luis Eduardo Echeverría  17 ; RECOLFACA Investigators
Affiliations

Eligibility of sodium-glucose cotransporter-2 inhibitors in heart failure with preserved ejection fraction: Insights from the Colombian heart failure registry (RECOLFACA)

Juan Esteban Gómez-Mesa et al. Int J Cardiol Heart Vasc. .

Abstract

Background: The value of Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitor) therapy in individuals with heart failure with preserved EF (HFpEF) was unknown until the EMPEROR-Preserved trial. We aimed to assess the proportion of patients with HFpEF that are eligible for empagliflozin therapy within the Colombian Heart Failure Registry (RECOLFACA).

Methods: RECOLFACA enrolled adult patients with a HF diagnosis during 2017-2019 from 60 medical centers in Colombia. Criteria of the EMPEROR-Preserved Trial were used to recruit participants. The main outcome was individual eligibility with N-terminal pro-B-type natriuretic peptide (NT-proBNP) criteria, while the secondary outcome was eligibility without NT-proBNP data.

Results: RECOLFACA had 799 patients with HFpEF (mean age70.7 ± 13.5; 50.7 % males). According to the major selection criteria of the EMPEROR Preserved Trial, 73.7 % patients would be eligible for empagliflozin therapy initiation when considering the NT-proBNP threshold. The NT-proBNP threshold represented the main determinant of ineligibility in patients with this biomarker measure (13.6 %; n = 16). In patients without NT-proBNP data, the main reasons for exclusion were the diagnosis of symptomatic hypotension or a systolic blood pressure below 100 mmHg (7.5 %), having an eGFR < 20 ml/min/1.73 m2 (4.3 %), and haemoglobin < 9 g/dl (3.1 %). Excluding NT-proBNP criteria increased empagliflozin eligibility to 80.6 %.

Conclusion: Most patients with HFpEF from RECOLFACA are potential candidates for empagliflozin therapy initiation according to the EMPEROR-Preserved trial criteria. These findings favor the utilization of SGLT-2 inhibitor medications in daily medical practice, which may further decrease morbidity and mortality in HF patients, regardless of their EF classification.

Keywords: Colombia; Ejection fraction; Empagliflozin; Heart failure; SGLT-2 inhibitor.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Eligibility according to EMPEROR-Preserved criteria. Eligibility of patients with left ventricular ejection fraction (LVEF) > 40 % from the Colombian Heart Failure Registry (RECOLFACA), according to the N-terminal pro-B-type natriuretic peptide (NT-proBNP) criterion of the EMPEROR-preserved trial.
Fig. 2
Fig. 2
Prevalence of the most frequent exclusion criteria among patients with left ventricular ejection fraction (LVEF) > 40 % from the Colombian Heart Failure Registry (RECOLFACA).
See this image and copyright information in PMC

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