Pre-Operative Global Longitudinal Strain Predictive Of Long-Term Risk Of GI Bleeding In Patients Undergoing Ventricular Assist Device Placement
HFSA ePoster Library. Birs A. 09/10/21; 343507; 270
Dr. Antoinette Birs
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Abstract
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Background: Despite the success in the use of sodium-glucose cotransporter type 2 inhibitors ( SGLT2i) in chronic heart failure (CHF), the question of using SGLT2i for acute decompensation of CHF (ADHF) is open
Aims: To determine impact of dapagliflozine (DPG) on increase in diuretics dose and hyponatremia in ADHF
Materials and methods: Patients with ADHF presented to emergency hospital between 12\06\2020. and 04\25\2021 were randomized into two groups (DPG plus standard treatment vs standard treatment) The study was approved by local ethical committee Clin Trial #NCT04778787 P value <0.05 was considered to be significant
Results: 102 patients were included (57.8% males, average age 73.4±11.7 years). Average ejection fraction (EF) was 44.9 ± 14.7%. 55.9% of patients had ischemic CHF, 37% had preserved EF, 32% had diabetes mellitus. N-terminal pro b-type Natriuretic Peptide (NTproBNP) = 4706 [1757; 11244]. Estimated glomerular filtration rate (eGFR) = 51.6+19.5 ml \ min. Inhospital mortality was 7.8%. Intensive care unit admission (ICU) was 4.9% Patients in DPG group demonstrated significantly decrease in body weight (4.10[2.95; 5.75] vs. 3.00 [1.38;4.65]; P = 0.02) Admission GFR in the control group and in the DPG group was 52.8 ± 5.57 ml/min vs 54.2± 6.8 ml/min, respectively. At visit 2, there was a statistically insignificant decrease in GFR in the DPG group (52.4± 5.9 ml/min) compared with the control group (52.7 ±5.8 ml/min). At the discharge, the GFR was 55.1±6.4 ml/min and 53.8 ±6.8 ml/min in the control group and in the DPG group, respectively. There were no significant difference in GFR (1 day; discharge) or episodes of worsening renal function (WRF) in the DPG group. Episodes of WRF were 15.2% vs 34.4% (p = 0.07) - insignificantly more often with DPG.a Increase in diuretic dose or addition of other class (thiazide or acetazolamide) were less prevalent with DPG (20% vs 35%; P> 0.05;). Increase of Lasix dosing: 14.0% vs 29.4%, p = 0.05 (less often with DPG) At baseline, 17.6% of patients had hyponatremia (22% with DPG, 15% in control group). There was a decrease in sodium in the control group and an increase with DPG (-0.98 ± 1.6 vs 2.3± 2.3; p = 0.02). Hyponatremia persisted in 80.0% in the control group and 27.3% with DPG (p = 0.048).
Conclusion: Treatment ADHF with DPG results in more pronounced decrease in body weight, lesser episodes of increase in diuretic dose without significant impairment in renal function. DPG normalize serum sodium in 80% of hyponatremic patients
Aims: To determine impact of dapagliflozine (DPG) on increase in diuretics dose and hyponatremia in ADHF
Materials and methods: Patients with ADHF presented to emergency hospital between 12\06\2020. and 04\25\2021 were randomized into two groups (DPG plus standard treatment vs standard treatment) The study was approved by local ethical committee Clin Trial #NCT04778787 P value <0.05 was considered to be significant
Results: 102 patients were included (57.8% males, average age 73.4±11.7 years). Average ejection fraction (EF) was 44.9 ± 14.7%. 55.9% of patients had ischemic CHF, 37% had preserved EF, 32% had diabetes mellitus. N-terminal pro b-type Natriuretic Peptide (NTproBNP) = 4706 [1757; 11244]. Estimated glomerular filtration rate (eGFR) = 51.6+19.5 ml \ min. Inhospital mortality was 7.8%. Intensive care unit admission (ICU) was 4.9% Patients in DPG group demonstrated significantly decrease in body weight (4.10[2.95; 5.75] vs. 3.00 [1.38;4.65]; P = 0.02) Admission GFR in the control group and in the DPG group was 52.8 ± 5.57 ml/min vs 54.2± 6.8 ml/min, respectively. At visit 2, there was a statistically insignificant decrease in GFR in the DPG group (52.4± 5.9 ml/min) compared with the control group (52.7 ±5.8 ml/min). At the discharge, the GFR was 55.1±6.4 ml/min and 53.8 ±6.8 ml/min in the control group and in the DPG group, respectively. There were no significant difference in GFR (1 day; discharge) or episodes of worsening renal function (WRF) in the DPG group. Episodes of WRF were 15.2% vs 34.4% (p = 0.07) - insignificantly more often with DPG.a Increase in diuretic dose or addition of other class (thiazide or acetazolamide) were less prevalent with DPG (20% vs 35%; P> 0.05;). Increase of Lasix dosing: 14.0% vs 29.4%, p = 0.05 (less often with DPG) At baseline, 17.6% of patients had hyponatremia (22% with DPG, 15% in control group). There was a decrease in sodium in the control group and an increase with DPG (-0.98 ± 1.6 vs 2.3± 2.3; p = 0.02). Hyponatremia persisted in 80.0% in the control group and 27.3% with DPG (p = 0.048).
Conclusion: Treatment ADHF with DPG results in more pronounced decrease in body weight, lesser episodes of increase in diuretic dose without significant impairment in renal function. DPG normalize serum sodium in 80% of hyponatremic patients
Background: Despite the success in the use of sodium-glucose cotransporter type 2 inhibitors ( SGLT2i) in chronic heart failure (CHF), the question of using SGLT2i for acute decompensation of CHF (ADHF) is open
Aims: To determine impact of dapagliflozine (DPG) on increase in diuretics dose and hyponatremia in ADHF
Materials and methods: Patients with ADHF presented to emergency hospital between 12\06\2020. and 04\25\2021 were randomized into two groups (DPG plus standard treatment vs standard treatment) The study was approved by local ethical committee Clin Trial #NCT04778787 P value <0.05 was considered to be significant
Results: 102 patients were included (57.8% males, average age 73.4±11.7 years). Average ejection fraction (EF) was 44.9 ± 14.7%. 55.9% of patients had ischemic CHF, 37% had preserved EF, 32% had diabetes mellitus. N-terminal pro b-type Natriuretic Peptide (NTproBNP) = 4706 [1757; 11244]. Estimated glomerular filtration rate (eGFR) = 51.6+19.5 ml \ min. Inhospital mortality was 7.8%. Intensive care unit admission (ICU) was 4.9% Patients in DPG group demonstrated significantly decrease in body weight (4.10[2.95; 5.75] vs. 3.00 [1.38;4.65]; P = 0.02) Admission GFR in the control group and in the DPG group was 52.8 ± 5.57 ml/min vs 54.2± 6.8 ml/min, respectively. At visit 2, there was a statistically insignificant decrease in GFR in the DPG group (52.4± 5.9 ml/min) compared with the control group (52.7 ±5.8 ml/min). At the discharge, the GFR was 55.1±6.4 ml/min and 53.8 ±6.8 ml/min in the control group and in the DPG group, respectively. There were no significant difference in GFR (1 day; discharge) or episodes of worsening renal function (WRF) in the DPG group. Episodes of WRF were 15.2% vs 34.4% (p = 0.07) - insignificantly more often with DPG.a Increase in diuretic dose or addition of other class (thiazide or acetazolamide) were less prevalent with DPG (20% vs 35%; P> 0.05;). Increase of Lasix dosing: 14.0% vs 29.4%, p = 0.05 (less often with DPG) At baseline, 17.6% of patients had hyponatremia (22% with DPG, 15% in control group). There was a decrease in sodium in the control group and an increase with DPG (-0.98 ± 1.6 vs 2.3± 2.3; p = 0.02). Hyponatremia persisted in 80.0% in the control group and 27.3% with DPG (p = 0.048).
Conclusion: Treatment ADHF with DPG results in more pronounced decrease in body weight, lesser episodes of increase in diuretic dose without significant impairment in renal function. DPG normalize serum sodium in 80% of hyponatremic patients
Aims: To determine impact of dapagliflozine (DPG) on increase in diuretics dose and hyponatremia in ADHF
Materials and methods: Patients with ADHF presented to emergency hospital between 12\06\2020. and 04\25\2021 were randomized into two groups (DPG plus standard treatment vs standard treatment) The study was approved by local ethical committee Clin Trial #NCT04778787 P value <0.05 was considered to be significant
Results: 102 patients were included (57.8% males, average age 73.4±11.7 years). Average ejection fraction (EF) was 44.9 ± 14.7%. 55.9% of patients had ischemic CHF, 37% had preserved EF, 32% had diabetes mellitus. N-terminal pro b-type Natriuretic Peptide (NTproBNP) = 4706 [1757; 11244]. Estimated glomerular filtration rate (eGFR) = 51.6+19.5 ml \ min. Inhospital mortality was 7.8%. Intensive care unit admission (ICU) was 4.9% Patients in DPG group demonstrated significantly decrease in body weight (4.10[2.95; 5.75] vs. 3.00 [1.38;4.65]; P = 0.02) Admission GFR in the control group and in the DPG group was 52.8 ± 5.57 ml/min vs 54.2± 6.8 ml/min, respectively. At visit 2, there was a statistically insignificant decrease in GFR in the DPG group (52.4± 5.9 ml/min) compared with the control group (52.7 ±5.8 ml/min). At the discharge, the GFR was 55.1±6.4 ml/min and 53.8 ±6.8 ml/min in the control group and in the DPG group, respectively. There were no significant difference in GFR (1 day; discharge) or episodes of worsening renal function (WRF) in the DPG group. Episodes of WRF were 15.2% vs 34.4% (p = 0.07) - insignificantly more often with DPG.a Increase in diuretic dose or addition of other class (thiazide or acetazolamide) were less prevalent with DPG (20% vs 35%; P> 0.05;). Increase of Lasix dosing: 14.0% vs 29.4%, p = 0.05 (less often with DPG) At baseline, 17.6% of patients had hyponatremia (22% with DPG, 15% in control group). There was a decrease in sodium in the control group and an increase with DPG (-0.98 ± 1.6 vs 2.3± 2.3; p = 0.02). Hyponatremia persisted in 80.0% in the control group and 27.3% with DPG (p = 0.048).
Conclusion: Treatment ADHF with DPG results in more pronounced decrease in body weight, lesser episodes of increase in diuretic dose without significant impairment in renal function. DPG normalize serum sodium in 80% of hyponatremic patients
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