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Real-world dapagliflozin treatment patterns in Portuguese patients with heart failure with reduced ejection fraction
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Introduction and objectives: Heart failure with reduced ejection fraction (HFrEF) poses a significant challenge to healthcare. While clinical trials have shown the therapeutic benefits of dapagliflozin in patients with HFrEF, it is essential to understand treatment patterns and patient characteristics in real-world settings. The EVOLUTION-HF study sought to address this gap by analyzing real-world data. Methods: EVOLUTION-HF is a retrospective cohort study conducted at eight sites in Portugal, which included patients who began treatment with dapagliflozin for HFrEF. Medical records were reviewed to collect information on the initiation date of dapagliflozin (the index date) and at the six- and 12-month follow-ups. Results: This study included 228 patients. The majority were male, with an average age of 65 years, a mean left ventricular ejection fraction of 29%, and 85% classified as NYHA class II. More prevalent comorbidities were dyslipidemia (59%) and arterial hypertension (56%). On the index date, baseline medications showed a high utilization of standard HFrEF therapies: 92% of patients received betablockers, 71% were on aldosterone antagonists, and 55% were taking angiotensin receptor-neprilysin inhibitors. At the end of the follow-up period, there was a significant increase in the dosage of beta-blockers and a decrease in the dosage of loop diuretics. A low discontinuation rate of 5% was observed for dapagliflozin. Conclusions: These findings support the established safety profile of dapagliflozin. The patient characteristics in the EVOLUTION-HF study closely resemble those in the DAPA-HF randomized trial. The observed treatment patterns indicate an optimization in guideline-directed medical therapy.
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Palavras-chave
Cardiovascular Dapagliflozin Heart failure Real-world Reduced ejection fraction SGLT2i Cardiology and Cardiovascular Medicine