Dapa Acute Heart Failure Study

Summary

Heart failure (HF) is one of the most important reasons for hospital admission and is associated with high mortality and morbidity. After discharge, up to 40% of patients are readmitted within 6 months and 1-year post-discharge mortality is high. The cost burden of treating patients with HF is high and \~80% of healthcare costs are related to hospital admissions. Sodium-glucose cotransporter-2 (SGLT2) inhibitor is considered one of the four foundational therapies (ACE-I or ARNI, beta-blockers, MRA, and SGLT2 inhibitors) for HFrEF. This is an investigator-initiated, prospective, single-centre, registry that evaluates the change in HRQL as measured by the KCCQ-TSS after the initiation of Dapagliflozin.

Eligibility

Inclusion Criteria:

1. Subject age \>18 hospitalized for primary diagnosis of acute HF
2. Dyspnoea (exertional or at rest) and 1 of the following signs:

   * Congestion on chest X-ray
   * Rales on chest auscultation
   * Clinically relevant oedema (e.g. ≥1+ on a 0 to 3+ scale)
   * Elevated jugular venous pressure
3. NT-proBNP ≥300 ng/L (If ongoing atrial fibrillation/flutter at recruitment, NT-pro BNP must be ≥ 600 pg/mL.4. 5).

Exclusion Criteria:

1. Cardiogenic shock
2. Current hospitalization for acute HF primarily triggered by pulmonary embolism or cerebrovascular accident.
3. Interventions in the past 30 days prior or planned during the study: Major cardiac surgery, or TAVI, or PCI, or MitraClip
4. Current or expected heart transplant, LVAD, on IABP or other forms of mechanical support.
5. Haemodynamically severe uncorrected primary cardiac valvular disease planned for surgery or intervention during the course of the study.
6. eGFR \<20 mL/min/1.73m2 as measured during index hospitalization (latest measurement before randomization) or patients requiring dialysis
7. Type 1 diabetes mellitus
8. History of ketoacidosis, including diabetic ketoacidosis
9. Prior treatment with SGLT2 inhibitors in 90 days prior to current admission.
10. Documented severe allergy or intolerance to SGLT2 inhibitors.
11. Pregnant subjects

Conditions2

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