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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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34. Public Health and Health Economics
35. Research Methodology
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EFFECT OF SGLT2 INHIBITORS IN SUSTAINED VENTRICULAR TACHYARRHYTHMIAS IN PATIENTS WITH IMPLANTABLE CARDIOVERTER DEFIBRILLATORS FOR PRIMARY PREVENTION
Session:
Sessão de Posters 28 - Morte súbita cardíaca
Speaker:
Julien Oliveira Lopes
Congress:
CPC 2024
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.4 Ventricular Arrhythmias and SCD - Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Julien Lopes; Inês Ferreira Neves; Guilherme Portugal; Rita Teixeira; Pedro Silva Cunha; Bruno Valente; Ana Lousinha; Paulo Osório; Helder Santos; André Monteiro; Rui Cruz Ferreira; Mário Martins Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Current guidelines recommend implantable cardioverter-defibrillators (ICD) in primary prevention for patients with heart failure (HF) and left ventricular ejection fraction (LVEF) ≤35%, and at least three months of optimal medical therapy. Recently, new pharmacologic treatments have been approved for patients with HF and reduced LVEF. We aimed to assess if the current treatment with sodium-glucose co-transporter 2 inhibitors (SGLT2i) has an impact on the long-term incidence of ventricular arrhythmias treated with appropriate ICD therapy in primary prevention patients. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> Retrospective study of a cohort of patients submitted to ICD implantation for primary prevention from January 2015 to December 2022. Appropriate ICD therapy (shocks or anti-tachycardia pacing) was noted during follow-up. We analyzed time to event (ICD therapy) between patients with (group A) and without SGLT2i (group B) treatment, using a Cox hazard regression model. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> 289 patients were included (male 82.4%, age 62±11 years, 67.5% ischemic heart disease, mean LVEF 28.1±5.2%). The median follow-up was 4.15 (IQR 3.85) years. Forty-five patients were on iSGLT2 (15.6%) and 241 were not on iSGLT2 (84.4%). There were no statistically significant differences between the two groups regarding comorbidities, LVEF and NYHA class. Statistically significant variables between the two groups where treatment with ACEi/ARB (group A - 18.2% vs. group B - 75.1%, p<0.001); ARNI (group A - 80% vs. group B - 20%, p<0.001) and MRA (group A - 91.1% vs. group B - 75.1%, p=0.018). Sixty-three patients received appropriate ICD therapy during follow-up (group A - 15.6% vs. group B - 23.2%, p=0.254). Cumulative hazard for appropriate ICD therapy estimations using cox regression was not statistically significant, despite a tendency for separation of the curves between groups. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> In our long-term study, treatment with SGLT2i had no statistically significant impact on the incidence of ventricular arrhythmias treated via ICD.</span></span></p>
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