Implementing in-hospital initiation of SGLT2 inhibitors in clinical practice

About this course

Despite improvements in the management of heart failure (HF), patients still face a significant risk of mortality and rehospitalisation following admission for acute HF. Congestion remains the primary cause of hospitalisation for patients with acute decompensated HF; each episode of HF decompensation can result in organ damage and have long-term consequences on patient outcomes. However, hospitalisation for HF presents an opportunity to adjust pharmacotherapy, making the in-hospital and early post-discharge periods an ideal time to initiate and optimise HF therapies, thus potentially improving patient outcomes – both immediately after discharge and in the long term.

In this presentation, Professor Christianne discusses the evidence supporting early in-hospital initiation and up-titration of guideline-directed medical therapy (GDMT) for patients with HF. Specifically, she explains the benefits of adding sodium-glucose cotransporter-2 (SGLT2) inhibitors for this patient group.

Learning outcomes

• Understand the pathophysiological aspects of acute HF versus chronic HF.
• Discuss evidence supporting in-hospital initiation and up-titration of GDMT.
• Explain the advantages of early initiation of SGLT2 inhibitors in clinical practice.
• Identify patients who would benefit from early initiation of SGLT2 inhibitors.

Topics covered

• Acute HF versus chronic heart failure.
• Effects of acute HF (mortality rate, hospitalisation rate, organ damage and rehospitalisation rate).
• Benefit of early intervention with GDMT including SGLT2 inhibitor after acute decompensation as demonstrated in pivotal trials:
• PIONEER-HF
• SOLOIST-WHF
• STRONG-HF
• EMPULSE
• Case presentation of patients with heart failure with reduced ejection fraction (HFrEF), heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) including recommendations from the latest European Society of Cardiology (ESC) guidelines and expert consensus.

Topics covered

• PIONEER-HF
• SOLOIST-WHF
• STRONG-HF
• EMPULSE

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