The goal of heart failure (HF) pharmacotherapy is to improve disease-related morbidity and mortality. Recent clinical trials demonstrated a reduction in cardiovascular death and HF-related hospitalizations with the addition of sodium glucose co-transporter 2 inhibitors (SGLT2i) in patients with HF with reduced ejection fraction (HFrEF) , as well as HF with preserved ejection fraction (HFpEF) with or without type 2 diabetes (T2D) . The objective of this study was to identify SGLT2i prescribing rates in these patients and to identify predictors of drug class utilization. The University of New Mexico (UNM) Health Sciences Center IRB approved this retrospective, single-center, descriptive study. Individuals ≥ 18 years with a diagnosis of HF, an eGFR of ≥ 20 ml/min/1.73m2, and a visit to the UNM Hospital system between August 17, 2020 to August 16, 2021 were included. Patients were excluded if they were diagnosed with type 1 diabetes or had no documented EF in their patient chart. A total of 2,905 patients with HF were identified, of which 1,101 were randomly reviewed. After exclusion, the study sample included: 377 with HFrEF, 335 with HFpEF, and 88 with HF with mid-range ejection fraction. The mean age was 65 years; 60% were female; 76% were white; 47% were Hispanic; and 49% had established atherosclerotic cardiovascular disease. Overall, 42% (n = 339) had T2D with a mean A1C of 8.0%. SGLT2is were prescribed in 6.5% of patients overall, 14.7% of patients with T2D, and 0.4% of patients without T2D. Predictors of SGLT2i prescribing were: T2D (OR = 38.4; 95% CI, 8.9 - 165.58) , HFrEF (OR = 3.7; 95% CI, 1.79 - 7.47) , having a cardiology provider (OR = 2.2; 95% CI, 1.79 - 7.47) , being seen by a pharmacist with prescriptive authority (OR = 4.1; 95% CI, 2.01 - 8.26) , and enrollment in UNM’s patient assistance program (OR = 2.3; 95% CI, 1.08 - 4.97) . Despite guideline recommendations, SGLT2is are underutilized in patients with HF with or without T2D. Future studies are needed to determine the barriers to utilization.

Disclosure

S. R. Bermudez: None. J. R. Anderson: None. G. Ray: None.

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