SGLT2i in Acute Heart Failure, The Earlier The Better?
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COMMENTARY

SGLT2 Inhibitors in Acute Heart Failure, The Earlier The Better? DICTATE AHF

Ileana L. Piña, MD, MPH; Zachary L. Cox, PharmD

Disclosures

September 20, 2023

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This transcript has been edited for clarity.

Ileana L. Piña, MD, MPH: Hello, and welcome. I'm Ileana Piña, professor of medicine at Thomas Jefferson University, and the chair of Quality. I am here at the European Society meetings with a large amount of excitement and many new trials that are being presented. That's exactly why we have my friend here, Dr Cox, who comes from Vanderbilt, to talk to us bit about DICTATE-AHF.

If it starts with a D, then we know it's dapagliflozin. Tell me, why did we think a sodium-glucose cotransporter 2 (SGLT2) [inhibitor] would do anything in acute heart failure? We're terrible at acute decompensation. We're awful. Why did you put it together that way?

DICTATE-AHF: Dapagliflozin in Acute Heart Failure

Zachary L. Cox, PharmD: Thank you so much for the opportunity to talk with you. When we looked at the space of acute heart failure, as you just laid out, we know that starting an SGLT2 inhibitor in the ambulatory setting or at hospital discharge and continuing it chronically has widespread benefit across patients, regardless of ejection fraction.

However, what we didn't know was that when starting it acutely on the first day of heart failure hospitalization, (1) does it provide any acute efficacy, and (2) is it safe

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