Li Jiaying, Wang Xiaoyan, Zheng Qianwei, Tian Jing, Chen Huanzhen, Yao Simin
Department of Cardiology, the 1st Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, 030001, Shanxi Province, China.
Department of Cardiology, Grand Hospital of Shuozhou, No. 189, Guang'an East Street, Shuocheng District, Shuozhou, 036000, Shanxi Province, China.
BMC Cardiovasc Disord. 2025 Jul 4;25(1):485. doi: 10.1186/s12872-025-04952-w.
Heart failure with reduced ejection fraction (HFrEF) and cognitive impairment are significant challenges faced by global healthcare systems. Clinical studies on the impact of drugs for HFrEF on cognitive impairment are very limited. We aimed to assess the effects of regular use of Sodium-Glucose cotransporter 2 inhibitor (SGLT2i) on cognitive impairment in elderly inpatients with HFrEF.
A single center prospective cohort was conducted from October 2022 to October 2023. Inpatients ≥ 65 years old with HFrEF were evaluated. Cognitive function was assessed by the Chinese version of the Mini-Mental State Examination (MMSE), and patients with MMSE score < 27 were included in the study and followed up for 6 months. We divided the population into the groups of regular SGLT2i users (R-SGLT2i) and Non-regular SGLT2i users (Non-R-SGLT2i). A multivariate logistic regression model was used to determine the relationship between regular use of SGLT2i and MMSE score.
A total of 113 elderly hospitalized HFrEF patients with cognitive impairment were completed the study, and 54 (47.8%) patients were in R-SGLT2i, and 67.9% were male. The baseline MMSE score for the Non-R-SGLT2i and R-SGLT2i were 20.03 ± 1.50 and 20.19 ± 1.92 ( = 0.640). After 6 months of follow-up and reevaluation, the MMSE score of the Non-R-SGLT2i and R-SGLT2i were 19.78 ± 1.99 and 22.28 ± 1.76 ( < 0.001). After adjusting for age, education, left ventricular ejection fraction and type 2 diabetes, the regular use of SGLT2i was associated with higher MMSE score [OR = 3.22, 95% CI (1.37–7.55), = 0.007].
This study shows that regular use of SGLT2i have an improving effect on cognitive impairment in elderly HFrEF patients.
ChiCTR2200066070; date of registration: 11/23/2022.
The online version contains supplementary material available at 10.1186/s12872-025-04952-w.
射血分数降低的心力衰竭（HFrEF）和认知障碍是全球医疗系统面临的重大挑战。关于治疗HFrEF的药物对认知障碍影响的临床研究非常有限。我们旨在评估长期使用钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）对老年HFrEF住院患者认知障碍的影响。
于2022年10月至2023年10月进行了一项单中心前瞻性队列研究。对年龄≥65岁的HFrEF住院患者进行评估。采用中文版简易精神状态检查表（MMSE）评估认知功能，MMSE评分<27分的患者纳入研究并随访6个月。我们将研究人群分为长期使用SGLT2i组（R-SGLT2i）和非长期使用SGLT2i组（非R-SGLT2i）。采用多因素逻辑回归模型确定长期使用SGLT2i与MMSE评分之间的关系。
共有113例患有认知障碍的老年HFrEF住院患者完成了研究，其中54例（47.8%）患者属于R-SGLT2i组，男性占67.9%。非R-SGLT2i组和R-SGLT2i组的基线MMSE评分分别为20.03±1.50和20.19±1.92（P = 0.640）。经过6个月的随访和重新评估，非R-SGLT2i组和R-SGLT2i组的MMSE评分分别为19.78±1.99和22.28±1.76（P<0.001）。在调整年龄、教育程度、左心室射血分数和2型糖尿病后，长期使用SGLT2i与较高的MMSE评分相关[比值比（OR）=3.22，95%置信区间（CI）（1.37 - 7.55），P = 0.007]。
本研究表明，长期使用SGLT2i对老年HFrEF患者的认知障碍有改善作用。
中国临床试验注册中心注册号：ChiCTR2200066070；注册日期：2022年11月23日。
在线版本包含可在10.1186/s12872-025-04952-w获取的补充材料。
