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December 2021

First treatment shown to benefit patients with HFpEF

SGLT2 inhibitors, originally developed to treat type 2 diabetes, are now widely recommended for patients with heart failure, but until now no single treatment has been shown to improve outcomes for patients with heart failure with preserved ejection fraction (HFpEF).

But findings published this month show that SGLT2 inhibitors could provide ‘real benefit’ for this group of patients, and researchers say it could revolutionise treatment.

Lead researcher Prof Vass Vassiliou, from UEA’s Norwich Medical School and an Honorary Consultant Cardiologist at the Norfolk and Norwich University Hospital, said patients were equally split between heart failure with reduced ejection fraction (HFrEF) and HFpEF. ‘For many years there was not a single medicine that could improve the outcome in patients with the second type of heart failure – those patients with preserved ejection fraction. This type of heart failure had puzzled doctors, as every medicine tested showed no benefit.’

The research team undertook a meta-analysis of all studies published in the field and brought together data from almost 10,000 patients. They used statistical modelling to show the specific effect of these medicines.

Prof Vassiliou said: ‘We found that patients taking SGLT2 inhibitors were 22% less likely to die from heart-related causes or be hospitalised for heart failure exacerbation than those taking placebo.

‘This is the first medication that can provide a benefit to this previously untreatable group of patients – in terms of heart-related deaths or hospitalisation – and it will revolutionise the treatment offered to heart failure patients,’ he added.

However, the analysis found no benefit for overall mortality in HFpEF, indicating that the other comorbidities associated with heart failure play a significant role, and further research is needed.

Tsampasian V, et al. Eur J Prev Cardiol 2021 Dec 1.

Practice Nurse 2021;51(10):10