Scientists find new treatment for acute heart failure

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Researchers from Vanderbilt University Medical Center (VUMC) and Lipscomb University College of Pharmacy have discovered a promising new approach to treat acute heart failure, a major health issue that leads to numerous hospitalizations and deaths each year.

Their findings center around dapagliflozin, a drug originally approved for managing type 2 diabetes.

Recent studies have shown that dapagliflozin can also lower the risk of hospitalization and death from heart failure, particularly in patients with additional health concerns like chronic kidney disease and cardiovascular risks.

The research, published in the Journal of the American College of Cardiology, highlights the benefits of starting dapagliflozin treatment early during hospitalization for acute heart failure.

The drug helps remove excess fluid from the lungs, easing congestion, and has been shown to reduce the length of hospital stays.

Zachary Cox, PharmD, professor of Pharmacy Practice at Lipscomb University, noted the significance of their results, stating, “Initiating dapagliflozin within the first day of hospital admission for acute heart failure is safe and effective, and it could change how this condition is treated globally.”

Acute heart failure is a prevalent issue in the U.S., with around 800,000 patients admitted to hospitals annually from emergency rooms.

These patients often face long hospital stays and a high risk of death. The financial burden of treating acute heart failure in the U.S. is immense, exceeding $34 billion each year.

Typically, diuretics are used to treat patients with acute heart failure to alleviate symptoms and lung congestion caused by fluid buildup. However, the effectiveness and optimal strategy for diuretic therapy in these cases are still unclear.

This uncertainty contributes to extended hospital stays and high rates of death and readmissions.

Moreover, many patients do not adequately respond to diuretics, and about half are discharged with ongoing congestion, leading to frequent hospital readmissions for further treatment.

Dapagliflozin works differently by inhibiting the sodium-glucose cotransporter 2 (SGLT2) in the kidneys, which increases the removal of sodium and glucose from the body.

This mechanism not only helps in managing blood sugar levels but also promotes the elimination of excess fluids.

The clinical trial, led by VUMC’s JoAnn Lindenfeld, MD, and Sean Collins, MD, MSc, along with Zachary Cox, was launched in April 2020.

Despite challenges posed by the COVID-19 pandemic, the team successfully enrolled 240 patients from multiple sites, including VUMC, TriStar Centennial Medical Center, and Ascension St. Thomas Hospital West in Nashville, the University of North Carolina at Chapel Hill, the University of Mississippi Medical Center in Jackson, and INTEGRIS Health Baptist Medical Center in Oklahoma City.

Patients were randomized within 24 hours of their hospital admission to receive either dapagliflozin or standard diuretic treatment.

The results showed that while dapagliflozin did not increase the efficiency of diuretics based on weight, it led to no additional adverse events, reduced the need for intravenous diuresis, and allowed for quicker patient discharges compared to those who received conventional treatment.

The study underscores the dual benefits of dapagliflozin in improving fluid removal and setting the stage for ongoing outpatient care that reduces the risk of readmission.

This finding marks a significant advancement in the treatment of acute heart failure, offering hope for better patient outcomes and more efficient healthcare delivery.

If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and herbal supplements could harm your heart rhythm.

For more information about health, please see recent studies that olive oil may help you live longer, and vitamin D could help lower the risk of autoimmune diseases.

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