Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
SGLT2 inhibitors in a post-acute coronary syndrome population
Session:
Painel 5 - E-Cardiologia e Saúde Publica 1
Speaker:
Nuno Craveiro
Congress:
CPC 2020
Topic:
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
Theme:
34. Public Health and Health Economics
Subtheme:
34.1 Public Health
Session Type:
Posters
FP Number:
---
Authors:
Nuno Craveiro; Kevin Domingues; Bruno Miranda Castilho; Ana Rita Moura; Mariana Saraiva; Marisa Peres; Vitor Paulo Martins
Abstract
<p><strong>Introduction </strong>Sodium glucose type 2 inhibition (SGLT2i) drugs are an emerging therapeutic class changing the paradigm of type II diabetes mellitus (DM2) treatment in patients with high cardiovascular risk or with established cardiovascular disease. Recently published data also shows a reduction in cardiovascular events with SLGT2i therapy in heart failure patients with reduced ejection fraction (HFREF), even without DM. DM2 is a frequent comorbidity in ischemic cardiomyopathy, which is the most common etiology of HFREF.</p> <p><strong>Objective </strong>To analyse eligibility and possible reduction of cardiovascular outcomes with SGLT2i therapy in a post-acute coronary syndrome (ACS) population.</p> <p><strong>Methods </strong>We analysed a database of ACS patients admitted to a district hospital from 2011 to 2018. Eligibility criteria and effectiveness were considered based on the 2019 ESC guidelines of Diabetes, Pre-Diabetes and Cardiovascular Diseases and EMPA-REG OUTCOME, DECLARE-TIMI 58, CANVAS, CREDENCE, DAPA-HF trials.</p> <p><strong>Results </strong>There was a total of 1335 patients admitted with ACS, 33% (n=439) STEMI and 67% (N=896) NSTEMI/UA. Mean age was 69±13 years, 67% (n=895) were men, 74% (n=993) had arterial hypertension, 18% (n=243) were smokers, 42% (n=558) had dyslipidemia, and 37% (n=497) had DM, including 14 patients with type I DM. Of the 483 DM2 patients, 86% (n=418) had an estimated glomerular filtration rate (eGFR) > 30ml/min/1.73m<sup>2</sup>. Within the DM2 population, 16 (3.3%) patients were diagnosed at the index event, 38 (10%) were under dietary and lifestyle therapy only, 330 (66%) under oral pharmacologic treatment and 99 (20%) under insulin therapy. Mean HbA1c was 7.83±1.64%. Transthoracic echocardiography after the acute event revealed reduced ejection fraction (<40%) in 267 patients (20%) of the total population, with a mean BNP of 1179±1042 pg/mL. Of these, 110 patients didn’t have DM diagnosis and had eGFR > 30ml/min/1.73m2. In total, 528 patients (40%) of this post-ACS population could be eligible for SGLT2i. If this therapy had been used in this population, allcause mortality at follow-up could have been reduced from 12,48% to 8,48%, death from cardiovascular causes from 5,02 to 3,11% and hospitalization for heart failure from 8.3% to 5,81%.</p> <p><strong>Conclusion </strong>A large proportion of patients (40%) could have been eligible for SGLT2i therapy, either as a first line therapy in “naïve” patients or “on-top” of metformin/insulin therapy in DM2 patients with adequate eGFR, with a significant improvement in cardiovascular outcomes. In the near future, HFREF patients (even without diabetes) could be included for treatment with SGLT2i in order to further reduce the risk of death and CV events.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site