'A Missed Therapeutic Opportunity? SGLT-2 Inhibitor Use in General Medicine Patients With Heart Failure: A Retrospective Audit of Admissions to a Tertiary Health Service'.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
ACS Applied Bio Materials Pub Date : 2022-10-27 eCollection Date: 2022-01-01 DOI:10.1177/11795468221133607
Padeepa Perera, Ronan O'Donnabhain, Timothy Fazio, Douglas Johnson, Peter Lange
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引用次数: 1

Abstract

Objective: Sodium-glucose co-transporter-2 inhibitors (SGLT2-I's) are novel oral hypoglycaemic agents, with proven decreased MACE and re-hospitalisation risk in type 2 diabetic patients with concomitant heart failure. This study aimed to assess the current practice in the use of SGLT2-I's in general medical units at a large metropolitan health service.

Methods/results: A retrospective audit was conducted of patients admitted to general medicine over a 12 month period (between April 2018 and 2019). Inclusion criteria included decompensated heart failure of any aetiology and ejection fraction, and type 2 diabetes mellitus with an HbA1c ⩾ 7 within 6 months of the admission period. A total of 150 admissions fulfilled criteria. Baseline demographics and comorbidities identified an older, more comorbid population than reference trials. These included age (75% over 75 years), smoking history (46%), hypertension (83%), chronic kidney disease grade IV or V (26%), previous myocardial infarction (57%), stroke (18%), atrial fibrillation (55%) and known left ventricular ejection fraction < 50% (38%). Co-prescribed medications included ACE-I/ARB (53%), beta-blocker (67%), loop diuretic (87%), thiazide (7%), MRA (31%), insulin (57%), metformin (47%), sulphonylurea (31%), DPP-4 Inhibitor (21%), GLP-1 analogue (6%) and 15% of patients had an HbA1c > 10. There was a significant difference between patients in our study eligible for and prescribed metformin (66/111) compared to SGLT-2 inhibitors (4/25) (P = .013). A total of 26 patients had readmissions within 28 days, of which one had been discharged on an SGLT2-I.

Conclusion: The results of this study identified significant under prescribing of SGLT2-I's in eligible type 2 diabetic patients with heart failure admitted under general medicine.

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错过的治疗机会?SGLT-2抑制剂在普通内科心力衰竭患者中的应用:对三级医疗服务机构入院情况的回顾性审计
目的:钠-葡萄糖共转运蛋白-2抑制剂(SGLT2-I’s)是一种新型口服降糖药,可降低2型糖尿病合并心力衰竭患者的MACE和再住院风险。本研究旨在评估目前在大型都市卫生服务机构的普通医疗单位使用SGLT2-I的做法。方法/结果:对2018年4月至2019年4月12个月期间住院的普通科患者进行回顾性审计。纳入标准包括任何病因和射血分数的失代偿性心力衰竭,以及入院期6个月内HbA1c大于或等于7的2型糖尿病。总共有150人符合标准。与参考试验相比,基线人口统计学和合并症确定了年龄更大,合并症更多的人群。这些因素包括年龄(75岁以上75%)、吸烟史(46%)、高血压(83%)、慢性肾脏疾病IV级或V级(26%)、既往心肌梗死(57%)、中风(18%)、心房颤动(55%)和已知左室射血分数10。与SGLT-2抑制剂(4/25)相比,我们研究中符合条件和处方的二甲双胍患者(66/111)之间存在显著差异(P = 0.013)。共有26例患者在28天内再次入院,其中1例患者使用SGLT2-I出院。结论:本研究的结果表明,在普通内科住院的符合条件的2型糖尿病合并心力衰竭患者中,SGLT2-I的处方明显不足。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
期刊介绍: ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.
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