Potential global impact of sodium‐glucose cotransporter‐2 inhibitors in heart failure

Talha, K. M. et al. (2023) Potential global impact of sodium‐glucose cotransporter‐2 inhibitors in heart failure. European Journal of Heart Failure, 25(7), pp. 999-1009. (doi: 10.1002/ejhf.2864) (PMID:37062865)

Abstract

Aims: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are effective across the spectrum of the left ventricular ejection fraction (LVEF) in heart failure (HF); however, population-wide medication use in eligible patients remains suboptimal. We evaluated the potential implications of optimal global implementation of SGLT-2 inhibitors in HF. Methods and Results: A decision analytical study was performed using the global prevalence of HF from the Global Burden of Disease 2017 report. Exclusion criteria were applied using the NHANES to ascertain an SGLT-2 inhibitor-eligible population, which was mapped onto global LVEF distributions from the REPORT-HF registry. The number needed to treat for 3 years for the composite of worsening HF events and cardiovascular deaths was calculated from estimated event rates in the EMPEROR-Reduced, EMPEROR-Preserved, DAPA-HF, and DELIVER trials and projected onto the eligible population. An estimated 49,329,000 (95%CI, 43,882,000–54,929,000) HF patients would be eligible for SGLT-2 inhibitors across all LVEFs, including 25,651,000 (95%CI, 22,818,000–28,563,000) with LVEF of <40% and 23,678,000 (95%CI, 21,063,000–26,366,000) with LVEF >40%. Optimal implementation of SGLT-2 inhibitors would be projected to prevent/postpone 4,512,011 (95%CI, 4,013,686–5,024,232) to 5,986,943 (95%CI, 5,325,721–6,666,604) total worsening HF events and cardiovascular deaths over 3 years in patients with LVEF <40%. An additional 2,102,606 (95%CI, 1,870,394–2,341,301) to 2,557,224 (95%CI, 2,274,804–2,847,528) events would be prevented/postponed in patients with LVEF >40%. Among all eligible HF patients, irrespective of LVEF, 7,069,235 (95%CI, 6,288,490–7,871,760) to 8,089,549 (95%CI, 7,196,115–9,007,905) total worsening HF events and cardiovascular deaths would be prevented/postponed over this period. Conclusions: Optimal implementation of SGLT-2 inhibitors globally in HF is projected to prevent approximately 7-8 million worsening HF events and cardiovascular deaths over 3 years.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Docherty, Dr Kieran and McMurray, Professor John
• Authors: Talha, K. M., Butler, J., Greene, S. J., Aggarwal, R., Anker, S. D., Claggett, B. L., Docherty, K. F., Solomon, S. D., McMurray, J. J.V., Januzzi, J. L., Vaduganathan, M., and Fonarow, G. C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: European Journal of Heart Failure
• Publisher: Wiley
• ISSN: 1388-9842
• ISSN (Online): 1879-0844
• Published Online: 16 April 2023
• Copyright Holders: Copyright © 2023 European Society of Cardiology
• First Published: First published in European Journal of Heart Failure 25(7):999-1009
• Publisher Policy: Reproduced in accordance with the publisher copyright policy