Optimizing sodium-glucose co-transporter 2 inhibitor use in patients with heart failure with reduced ejection fraction: A collaborative clinical practice statement

摘要: Abstract Heart failure with reduced ejection fraction (HFrEF) is a debilitating disease that associated substantial morbidity, mortality, and societal costs. The past three decades have brought about significant advancements in the pharmacologic management of HFrEF, corresponding reduction morbidity mortality. However, progress to improve clinical outcomes real-world settings has stalled recent years, largely due underutilization guideline directed medical therapies (GDMT). discovery cardio-renal protection from sodium-glucose co-transporter 2 inhibitors (SGLT2i) ushered new treatment paradigm for HFrEF SGLT2i therapy becoming an essential component GDMT. Our Preventive Cardiology Failure services established innovative, multi-disciplinary, collaborative protocol optimize cardiovascular risk factors facilitation use patients HFrEF. goal this collaboration enhance utilization safety by circumventing medication access issues, major obstacle initiation. Within protocol, our heart providers identify addition background patient then referred preventive cardiology where team performs comprehensive assessment, optimizes factors, initiates emphasis on access, cost minimization, mitigation potential side effects. assumes responsibility modification failure-based therapies, manages diabetes, lipid, metabolic-based therapies. followed both structured fashion, comparing outcome measures at regular intervals utilizing registry bio-repository. This practice statement provides detailed evidentiary review renal benefits SGLT2i, outlines rational creation details program may serve as template enhanced other health systems, addresses challenges encountered recommendations use.