589 THE EFFECT OF DAPAGLIFLOZIN ON SYMPTOMS, QUALITY OF LIFE AND ECHOCARDIOGRAPHIC PARAMETERS IN A REAL-WORLD POPULATION OF HFREF PATIENTS


 
 
 Large cardiovascular (CV) trials enrolling patients with type 2 diabetes showed that sodium glucose co-transporter-2 inhibitors (SGLT2i) significantly decreased heart failure (HF) hospitalization, both in patients with or without a history of HF.
 Accordingly, DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure)
 demonstrated the efficacy of dapagliflozin, for the reduction of CV death/HF hospitalization in patients with HF with reduced ejection fraction (HFrEF) regardless of type 2 diabetes status. However, there are still few real-word data and it is still not well known how early the clinical benefits are after the introduction of the drug into therapy; consequently, we aimed to evaluate the effect of dapagliflozin three months after its introduction in therapy in our real-world population.
 
 
 
 From February 2022 to September 2022 we introduced Dapagliflozin in 23 HFrEF patients’ therapy and we collected data of 11 patients (66.78±3.96 years; 89% men) at 3-months-FU. Specifically, on the first visit we collected the clinical, laboratory and echocardiographic parameters and dapagliflozin was added to optimal medical therapy of patients; then, the patients were evaluated after 3 months (follow-up).
 
 
 
 At follow-up, all patients were free from side effects and we did not record statistically significant differences in laboratory parameters and/or blood pressure values.
 As regards the echocardiographic parameters, there was an improvement in FE (28.11±2.95 vs 37.00±5.71%, p0.17), PAPS (46.89±3.94 vs 37.63±5.27mmHg, p0.17), and LVEDVind (75.34±10.58 vs 57.20±13.55 ml/m2, p0.30), although not statistically significant. Moreover, we observed a statistically significant reduction in the diameter of the inferior vena cava (18.89±1.78 vs 11.5±1.15 mm, p<0.01), in NYHA class (2.78±0.15 vs 2±0, p<0.001), in basal SO2 (95.67±0.78 vs 97.67±0.47%, p0.04) and an improvement of quality of life (EQ5Dtot 73.33±4.71 vs 86.67±4.41, p0.05; pain/discomfort 3.67±0.29 vs 4.78±0.22, p<0.01; anxiety/depression 3.67±0.29 vs 4.67±0.24, p0.0163). Finally, we recorded a not statistically significant reduction in the amount of mineralocorticoid receptor antagonists (MRAs) at follow-up (62.5±12.5 vs 37.5±5.59 mg of eplerenone, p0.09).
 
 
 
 Dapagliflozin improved symptoms, and quality of life in patients with HFrEF of our real world population already after 12 weeks, accordingly with previous data of DEFINE-HF trial. Moreover, already after 3 months was possible to record improvements in the echocardiographic parameters, even if they are not statistically significant. Certainly, it will be necessary to continue with the study to evaluate these results on a larger sample.
