Kocabas Umut, Ergin Isil, Yavuz Veysel, Altın Cihan, Kaplan Mehmet, Yılmaz Öztekin Gülsüm Meral, Doğduş Mustafa, Murat Selda, Murat Bektaş, Kıvrak Tarık, Karabulut Dilay, Kaya Ersin, Özdemir İbrahim Halil, Yıldız Cennet, Salkın Fatma Özge, Özçalık Emre, Polatkan Şeyda Günay, Çakan Fahri, Şen Taner, Karabulut Umut, Çakal Sinem, Oflar Ersan, Sinan Ümit Yaşar, Yenerçağ Mustafa, Türk Uğur Önsel
Department of Cardiology, Başkent University İzmir Hospital, İzmir, Türkiye.
Department of Public Health, Faculty of Medicine, Ege University, İzmir, Türkiye.
ESC Heart Fail. 2025 Feb;12(1):434-446. doi: 10.1002/ehf2.15049. Epub 2024 Sep 28.
We aimed to determine the use of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and to identify clinical factors associated with their use in patients with heart failure (HF) in a real-life setting.
Real-world data on Empagliflozin and Dapagliflozin use in patients with HEART failure: The RED-HEART study is a multicentre, cross-sectional and observational study that included HF patients in the outpatient setting regardless of ejection fraction from 19 cardiology centres between August 2023 and December 2023.
The study population consisted of 1923 patients with HF, predominantly men (61.2%), with a median age of 66 (range: 19-101) years. Overall, 925 patients (48.1%) were receiving SGLT2is. Among the study population, 22.1% had HF with preserved ejection fraction, 21.5% had HF with mildly reduced ejection fraction, 56.4% had HF with reduced ejection fraction and the use of SGLT2is was 42.0%, 47.9% and 50.6% in each group, respectively (P = 0.012). The use of SGLT2is was 76.6% in patients with HF and diabetes, 19.8% in patients with HF and chronic kidney disease and 26.8% in patients without diabetes and chronic kidney disease (P < 0.001). Higher education level [odds ratio (OR): 1.80; 95% confidence interval (CI): 1.06-3.05; P = 0.027], higher household income (OR: 3.46; 95% CI: 1.27-9.42; P = 0.015), New York Heart Association functional class IV (OR: 2.72; 95% CI: 1.16-6.35; P = 0.021), diabetes (OR: 9.42; 95% CI: 6.72-13.20; P < 0.001), the use of angiotensin receptor-neprilysin inhibitors (ARNis) (OR: 4.09; 95% CI: 2.39-7.01; P < 0.001), the use of mineralocorticoid receptor antagonists (MRAs) (OR: 2.02; 95% CI: 1.49-2.75; P < 0.001), the use of loop diuretics (OR: 1.62; 95% CI: 1.18-2.22; P = 0.003) and the use of thiazide diuretics (OR: 1.72; 95% CI: 1.30-2.29; P < 0.001) were independently associated with the use of SGLT2is. Conversely, atrial fibrillation (OR: 0.63; 95% CI: 0.45-0.88; P = 0.008), chronic kidney disease (OR: 0.53; 95% CI: 0.37-0.76; P = 0.001), the use of dihydropyridine calcium channel blockers (OR: 0.68; 95% CI: 0.48-0.98; P = 0.042) and the use of statins (OR: 0.67; 95% CI: 0.49-0.91; P = 0.010) were independently associated with the non-use of SGLT2is.
The RED-HEART study provided comprehensive real-world data about implementing SGLT2is in patients with HF. These results suggest that there is a need for organized action and close collaboration between healthcare providers to improve the implementation of SGLT2is, especially in patients with HF with preserved ejection fraction and chronic kidney disease.
我们旨在确定钠-葡萄糖协同转运蛋白2抑制剂（SGLT2is）的使用情况，并在现实环境中识别与心力衰竭（HF）患者使用这些药物相关的临床因素。
心力衰竭患者中恩格列净和达格列净使用的真实世界数据：RED-HEART研究是一项多中心、横断面观察性研究，纳入了2023年8月至2023年12月期间19个心脏病中心门诊环境中的HF患者，无论其射血分数如何。
研究人群包括1923例HF患者，以男性为主（61.2%），中位年龄为66岁（范围：19 - 101岁）。总体而言，925例患者（48.1%）正在接受SGLT2is治疗。在研究人群中，22.1%为射血分数保留的HF患者，21.5%为射血分数轻度降低的HF患者，56.4%为射血分数降低的HF患者，每组中SGLT2is的使用率分别为42.0%、47.9%和50.6%（P = 0.012）。HF合并糖尿病患者中SGLT2is的使用率为76.6%，HF合并慢性肾脏病患者中为19.8%，无糖尿病和慢性肾脏病患者中为26.8%（P < 0.001）。高等教育水平[比值比（OR）：1.80；95%置信区间（CI）：1.06 - 3.05；P = 0.027]、较高家庭收入（OR：3.46；95% CI：1.27 - 9.42；P = 0.015）、纽约心脏协会功能分级IV级（OR：2.72；95% CI：1.16 - 6.35；P = 0.021）、糖尿病（OR：9.42；95% CI：6.72 - 13.20；P < 0.
