Tag Archives: heart failure with reduced ejection fraction (HFrEF)

Introduction Dapagliflozin is a well-established treatment for type 2 diabetes mellitus (T2DM) that belongs to a class of medications called sodium-glucose cotransporter type 2 inhibitors (SGLT2i). It exerts its hypoglycaemic effect through reversibly inhibiting SGLT2 in the renal proximal convoluted tubule to reduce glucose re-absorption and increase urinary glucose excretion. Several well-designed randomised-controlled trials were conducted to assess the cardiovascular safety and efficacy of dapagliflozin, when administered at a dose of 10 mg once daily, in reducing cardiovascular events and related hospitalisations associated with heart f

Background Heart failure is a common cause of hospital admission in the UK, and the leading cause of admission in people aged 65 years or older.1 Treatment with angiotensin-converting enzyme (ACE) inhibitors (ACEi), angiotensin-receptor blockers (ARB) and beta blockers are associated with reduced morbidity and mortality, while prompt imaging with a transthoracic echocardiogram (TTE) enables earlier diagnosis and appropriate management.2 It has been recommended that a TTE should be done within 48 hours of admission. Coronavirus disease 2019 (COVID-19) was declared as a global pandemic on 11 March 2020,3 and the UK had 491,805 cases by 30 Septe

Introduction To date, five pharmacological approaches have been demonstrated to significantly reduce the risk of mortality and prevent hospitalisation for worsening heart failure (HF) in patients with HF with reduced ejection fraction (HFrEF): the combination of a neprilysin inhibitor and an angiotensin-receptor blocker (i.e. sacubitril/valsartan), a beta blocker, a mineralocorticoid-receptor antagonist (MRA) and a sodium-glucose co-transporter 2 (SGLT2) inhibitor. Hereafter, these five agents, which can be prescribed as four pills, will be referred to as the ‘four foundational therapies for HFrEF’.1-11 The combination of these four ther