Management of patients with chronic heart failure and type 2 diabetes mellitus: the SCODIAC-II study
- 17 October 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Internal and Emergency Medicine
- Vol. 16 (4), 895-903
- https://doi.org/10.1007/s11739-020-02528-4
Abstract
SCODIAC was a pilot study which revealed an increasing use of SGLT2i in 123 outpatients affected with Heart Failure (HF) and Type 2 Diabetes Mellitus. SCODIAC-II study, the second phase of the program, has been carried out to determine diagnostic and therapeutic pathways in a larger group of patients and to verify whether the use of innovative antidiabetic therapies could modify echocardiographic parameters and cardiovascular therapies. 406 HF-diabetic patients, referred to Cardiologists and Diabetologists of pertaining healthcare districts in Campania, were enrolled in this retrospective study and divided in Group A, composed of 136 patients with preserved Ejection Fraction (HF-pEF)(> 45%) and Group B, formed of 270 patients with reduced EF (HF-rEF)(≤ 45%). All patients had performed periodic clinical and echocardiographic evaluations. The antidiabetic therapies resulted modified after 1 year with a greater use of GLP1-AR, gliptins and SGLT2i. Cardiovascular therapies resulted also modified with a greater use of sacubitril/valsartan and a reduction of ACEi and ARBs in HF-rEF patients. Echocardiography E velocity, A velocity and E/e’ ratio resulted markedly reduced in 25 HF-pEF and in 60 HF-rEF patients treated with SGLT2i, in respect to both the whole sample of subjects at beginning and the other diabetic patients. LAVi resulted reduced only in HF-pEF patients and EF increased only in HF-rEF patients. The approach to the patients with HF and diabetes must necessarily take place in the healthcare districts, be multidisciplinary and integrated. SGLT2i could improve left ventricular function in HF-rEF patients and modify cardiovascular therapies, almost in this setting of patients. Trial registration The protocol was approved by the University of Naples Federico II Ethics Committee and registered at ClinicalTrial.gov (CT04375943). The principles outlined in the Declaration of Helsinki were followed.This publication has 26 references indexed in Scilit:
- Adherence to guidelines in the management of patients with chronic heart failure follow-up: role of periodic echocardiographic examinationsJournal of Cardiovascular Medicine, 2020
- Type 2 diabetes and heart failure: Characteristics and prognosis in preserved, mid-range and reduced ventricular functionDiabetes and Vascular Disease Research, 2018
- Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2018Diabetes Care, 2018
- Saxagliptin and Cardiovascular Outcomes in Patients with Type 2 Diabetes MellitusThe New England Journal of Medicine, 2013
- Alogliptin after Acute Coronary Syndrome in Patients with Type 2 DiabetesThe New England Journal of Medicine, 2013
- Comparative Safety and Effectiveness of Metformin in Patients With Diabetes Mellitus and Heart FailureCirculation: Heart Failure, 2013
- Risk of cardiovascular disease and all cause mortality among patients with type 2 diabetes prescribed oral antidiabetes drugs: retrospective cohort study using UK general practice research databaseBMJ, 2009
- The risk of developing coronary artery disease or congestive heart failure, and overall mortality, in type 2 diabetic patients receiving rosiglitazone, pioglitazone, metformin, or sulfonylureas: a retrospective analysisActa Diabetologica, 2009
- Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trialThe Lancet, 2005
- Role of diabetes in congestive heart failure: The Framingham studyThe American Journal of Cardiology, 1974