Sodium-Glucose Cotransporter-2 Inhibitors in Heart Failure with Preserved Ejection Fraction: Twelve Month Outcomes from a Real-World Perspective Cohort

Dr. Pritam Kitey, Dr. R. Manohari Shivakumar, Dr. Nitin Kumar

Heart Failure with Preserved Ejection Fraction; SGLT2 Inhibitors; Empagliflozin; Dapagliflozin; Real-World Evidence; KCCQ; Hospitalisation

Following landmark randomised trials, SGLT2 inhibitors have become standard therapy for heart failure with preserved ejection fraction (HFpEF), but real-world uptake and outcomes remain less well characterised in routine practice. We followed 287 patients with HFpEF prospectively for 12 months at a tertiary cardiology clinic, comparing those initiated on an SGLT2 inhibitor (empagliflozin or dapagliflozin; n = 152) with those not initiated (n = 135). Heart-failure hospitalisation occurred in 11.8% of the SGLT2i group versus 22.2% of the control group (adjusted HR 0.62, 95% CI 0.43-0.89). KCCQ Overall Summary Score improved by a mean of 15.4 points in the SGLT2i group versus 4.0 points in controls, and the proportion with NYHA class III-IV symptoms fell from 65% to 41% in the SGLT2i group compared with a smaller reduction in controls. Benefit was consistent across pre-specified subgroups, including those with diabetes, chronic kidney disease, and higher baseline NYHA class. Adverse events were manageable, with urinary tract and genital infections the most frequent.

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