Use of Sodium‐Glucose Cotransporter‐2 Inhibitors and Angiotensin Receptor‐Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real‐World Data
Background Contemporary use of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) and angiotensin receptor‐neprilysin inhibitors (ARNi) in patients with atrial fibrillation (AF) and heart failure (HF) has not been described. Methods and Results We analyzed the MarketScan databases for the period Jan...
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.032783 |
| _version_ | 1827314546490998784 |
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| author | Alvaro Alonso Alanna A. Morris Ashley I. Naimi Aniqa B. Alam Linzi Li Vinita Subramanya Lin Yee Chen Pamela L. Lutsey |
| author_facet | Alvaro Alonso Alanna A. Morris Ashley I. Naimi Aniqa B. Alam Linzi Li Vinita Subramanya Lin Yee Chen Pamela L. Lutsey |
| author_sort | Alvaro Alonso |
| collection | DOAJ |
| description | Background Contemporary use of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) and angiotensin receptor‐neprilysin inhibitors (ARNi) in patients with atrial fibrillation (AF) and heart failure (HF) has not been described. Methods and Results We analyzed the MarketScan databases for the period January 1, 2021 to July 30, 2022. Validated algorithms were used to identify patients with AF and HF, and to classify patients into HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF). We assessed the prevalence of SGLT2i and ARNi use overall and by HF type. Additionally, we explored correlates of lower use, including demographics and comorbidities. The study population included 60 927 patients (mean age, 75 years; 43% women) diagnosed with AF and HF (85% with HFpEF, 15% with HFrEF). Prevalence of ARNi use was 11% overall (30% in HFrEF, 8% in HFpEF), whereas the corresponding figure was 6% for SGLT2i (13% in HFrEF, 5% in HFpEF). Use of both medications increased over the study period: ARNi from 9% to 12% (22%–29% in HFrEF, 6%–8% in HFpEF), and SGLT2i from 3% to 9% (6%–16% in HFrEF, 2%–7% in HFpEF). Female sex, older age, and specific comorbidities were associated with lower use of these 2 medication types overall and by HF type. Conclusions Use of ARNi and SGLT2i in patients with AF and HF is suboptimal, particularly among women and older individuals, though use is increasing. These results underscore the need for understanding reasons for these disparities and developing interventions to improve adoption of evidence‐based therapies among patients with comorbid AF and HF. |
| first_indexed | 2024-04-24T22:36:55Z |
| format | Article |
| id | doaj.art-7adaedc839c14ea2a7c3fbe2e2a911d0 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T22:36:55Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-7adaedc839c14ea2a7c3fbe2e2a911d02024-03-19T10:07:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-03-0113610.1161/JAHA.123.032783Use of Sodium‐Glucose Cotransporter‐2 Inhibitors and Angiotensin Receptor‐Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real‐World DataAlvaro Alonso0Alanna A. Morris1Ashley I. Naimi2Aniqa B. Alam3Linzi Li4Vinita Subramanya5Lin Yee Chen6Pamela L. Lutsey7Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USADepartment of Medicine, School of Medicine Emory University Atlanta GA USADepartment of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USADepartment of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USADepartment of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USADepartment of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USALillete Heart Institute and Department of Medicine University of Minnesota School of Medicine Minneapolis MN USADivision of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USABackground Contemporary use of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) and angiotensin receptor‐neprilysin inhibitors (ARNi) in patients with atrial fibrillation (AF) and heart failure (HF) has not been described. Methods and Results We analyzed the MarketScan databases for the period January 1, 2021 to July 30, 2022. Validated algorithms were used to identify patients with AF and HF, and to classify patients into HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF). We assessed the prevalence of SGLT2i and ARNi use overall and by HF type. Additionally, we explored correlates of lower use, including demographics and comorbidities. The study population included 60 927 patients (mean age, 75 years; 43% women) diagnosed with AF and HF (85% with HFpEF, 15% with HFrEF). Prevalence of ARNi use was 11% overall (30% in HFrEF, 8% in HFpEF), whereas the corresponding figure was 6% for SGLT2i (13% in HFrEF, 5% in HFpEF). Use of both medications increased over the study period: ARNi from 9% to 12% (22%–29% in HFrEF, 6%–8% in HFpEF), and SGLT2i from 3% to 9% (6%–16% in HFrEF, 2%–7% in HFpEF). Female sex, older age, and specific comorbidities were associated with lower use of these 2 medication types overall and by HF type. Conclusions Use of ARNi and SGLT2i in patients with AF and HF is suboptimal, particularly among women and older individuals, though use is increasing. These results underscore the need for understanding reasons for these disparities and developing interventions to improve adoption of evidence‐based therapies among patients with comorbid AF and HF.https://www.ahajournals.org/doi/10.1161/JAHA.123.032783angiotensin receptor‐neprilysin inhibitorsatrial fibrillationheart failuresodium‐glucose cotransporter‐2 inhibitors |
| spellingShingle | Alvaro Alonso Alanna A. Morris Ashley I. Naimi Aniqa B. Alam Linzi Li Vinita Subramanya Lin Yee Chen Pamela L. Lutsey Use of Sodium‐Glucose Cotransporter‐2 Inhibitors and Angiotensin Receptor‐Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real‐World Data Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease angiotensin receptor‐neprilysin inhibitors atrial fibrillation heart failure sodium‐glucose cotransporter‐2 inhibitors |
| title | Use of Sodium‐Glucose Cotransporter‐2 Inhibitors and Angiotensin Receptor‐Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real‐World Data |
| title_full | Use of Sodium‐Glucose Cotransporter‐2 Inhibitors and Angiotensin Receptor‐Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real‐World Data |
| title_fullStr | Use of Sodium‐Glucose Cotransporter‐2 Inhibitors and Angiotensin Receptor‐Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real‐World Data |
| title_full_unstemmed | Use of Sodium‐Glucose Cotransporter‐2 Inhibitors and Angiotensin Receptor‐Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real‐World Data |
| title_short | Use of Sodium‐Glucose Cotransporter‐2 Inhibitors and Angiotensin Receptor‐Neprilysin Inhibitors in Patients With Atrial Fibrillation and Heart Failure From 2021 to 2022: An Analysis of Real‐World Data |
| title_sort | use of sodium glucose cotransporter 2 inhibitors and angiotensin receptor neprilysin inhibitors in patients with atrial fibrillation and heart failure from 2021 to 2022 an analysis of real world data |
| topic | angiotensin receptor‐neprilysin inhibitors atrial fibrillation heart failure sodium‐glucose cotransporter‐2 inhibitors |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.032783 |
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