RT Journal Article
T1 Renal function dynamics following co-administration of sacubitril/valsartan and empagliflozin in patients with heart failure and type 2 diabetes.
A1 de la Espriella, Rafael
A1 Bayés-Genís, Antoni
A1 Morillas, Herminio
A1 Bravo, Rafael
A1 Vidal, Verónica
A1 Núñez, Eduardo
A1 Santas, Enrique
A1 Miñana, Gema
A1 Sanchis, Juan
A1 Fácila, Lorenzo
A1 Torres, Francisco
A1 Górriz, Jose Luis
A1 Valle, Alfonso
A1 Núñez, Julio
K1 Heart failure with reduced ejection fraction (HFrEF)
K1 Renal function
K1 Renal safety profile
K1 SGLT2i
K1 Sacubitril/valsartan
K1 Type 2 diabetes mellitus
AB The aim of this study was to evaluate the safety profile in terms of changes in renal function after co-treatment with sacubitril/valsartan and empagliflozin in patients with type 2 diabetes (T2D) and heart failure with reduced ejection fraction (HFrEF). This multicentre observational analysis included 108 patients with T2D and HFrEF treated with both agents: baseline sacubitril/valsartan (Group A; n = 43), baseline empagliflozin (Group B; n = 42), or both agents initiated simultaneously (Group C; n = 23). The primary endpoint was estimated glomerular filtration rate (eGFR) dynamics across treatment groups. A binary characterization of worsening renal function (WRF)/improved renal function (IRF) was included in the primary endpoint. WRF and IRF were defined as an increase/decrease in serum creatinine ≥ 0.3 mg/dL or GFR ≥ 20%. Changes in quantitative variables were evaluated using joint modelling of survival and longitudinal data (JM). Rates and their treatment differences were determined by Poisson regression. The mean left ventricle ejection fraction and eGFR were 32 ± 6% and 70 ± 28 mL/min/1.73 m2 , respectively. At a median follow-up of 1.01 years (inter-quartile range 0.71-1.50), 377 outpatient visits were recorded. Although there were differences in GFR trajectories over time within each treatment, they did not achieve statistical significance (omnibus P = 0.154). However, when these differences were contrasted among groups, there was a significant decrease in GFR in Group A as compared with Group B (P = 0.002). The contrast between Groups C and B was not significant (P = 0.430). These differences were also reflected when the rates for WRF and IRF were contrasted among treatments. The co-administration of sacubitril/valsartan and empagliflozin in patients with HFrEF and concomitant T2D appears to be safe in terms of renal function.
YR 2020
FD 2020-09-22
LK https://hdl.handle.net/10668/26643
UL https://hdl.handle.net/10668/26643
LA en
DS RISalud
RD Apr 20, 2025