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
COMMENTARY
SGLT2 Inhibitors in Acute Heart Failure, The Earlier The Better? DICTATE AHF
Ileana L. Piña, MD, MPH; Zachary L. Cox, PharmD
DisclosuresSeptember 20, 2023
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
© 2023 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: SGLT2 Inhibitors in Acute Heart Failure, The Earlier The Better? DICTATE AHF - Medscape - Sep 20, 2023.
Tables
Authors and Disclosures
Authors and Disclosures
Authors
Ileana L. Piña, MD, MPH
Professor of Medicine/Cardiology/Heart Failure/Transplant; Quality Officer, Cardiovascular Line, Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania; Clinical Professor of Medicine, Central Michigan University College of Medicine, Mount Pleasant, Michigan; Adjunct Professor of Epidemiology and Biostatistics, Population & Quantitative Health Sciences, Case Western University, Cleveland, Ohio
Disclosure: Ileana L. Piña, MD, MPH, has disclosed the following relevant financial relationships:
Serve(d) as a director, office, partner, employee, advisor, consultant, or trustee for: US Food and Drug Administration; Center for Devices and Radiological Health
Zachary L. Cox, PharmD
Professor, Department of Pharmacy and Pharmaceutical Science, Lipscomb University College of Pharmacy; Heart Failure Clinical Pharmacy Specialist, Department of Pharmacy, Vanderbilt University Medical Center, Nashville, Tennessee
Disclosure: Zachary L. Cox, PharmD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Roche; Translational Catalyst
Received research grant from: AstraZeneca