Introduction: The prevalence of heart failure (HF) continues to increase and guidelines strongly recommend initiation of quadruple pharmacologic therapy including a sodium glucose co-transport 2 inhibitor (SGLT2i) for patients with all classifications of HF irrespective of type 2 diabetes (T2D). We previously conducted a study to characterize SGLT2i prescribing rates among patients with HF with or without T2D which demonstrated low utilization of SGLT2i at only 6.2%. A limitation of this study was that data was collected prior to the release of updated guidelines.
Objective & Methods: The objective of this study is to further describe prescribing patterns of SGLT2i in patients with HF. The University of New Mexico (UNM) Health Sciences Center IRB approved this retrospective, single-center, descriptive chart review. Individuals ≥ 18 years of age were included if they had a documented diagnosis of HF and had been seen in a UNM clinic defined as primary care, cardiology, heart failure, nephrology, or endocrinology from 12/2021 to 12/2023.
Results: A total of 395 patients were included in the study; 148 with HFrEF, 63 with HFmEF, and 184 with HFpEF. The mean age was 68 years; 44% were female; 54% were Hispanic, 66% had established atherosclerotic cardiovascular disease, and 47% had T2D. SGLT2i were prescribed in 28.1% of patients overall, 45.9% of patients with T2D, and 12.4% of patients without T2D. Predictors of SGLT2i prescribing include: T2D (OR= 4.6; 95% CI, 2.60-8.06), HFrEF (OR= 2.0, 95% CI 1.12-3.45), HF clinic visit (OR 1.8, 95% CI 1.01-3.14), visit with pharmacists having prescriptive authority (OR=4.6, 95% CI 1.96-10.88), and number of specialty provider visits (OR= 1.1, 95% CI 1.03-1.13).
Conclusion: SGLT2i utilization has increased since our previous study was conducted. However, SGLT2i continue to be underprescribed in patients with HF with or without T2D despite current guideline recommendations.
A. Winters: None. M. Lopez: None. G. Ray: None. J.R. Anderson: None.
