A recent study conducted by Vanderbilt University Medical Center (VUMC) and Lipscomb University College of Pharmacy in Nashville has found a potential new treatment for acute heart failure, a major cause of hospitalization and mortality. The drug, dapagliflozin, was originally approved for treating Type 2 diabetes but has also been discovered to lower the risk of hospitalization for heart failure and death in patients with severe health conditions.The article reports that a recent study in the Journal of the American College of Cardiology found that dapagliflozin can benefit patients with heart and chronic kidney disease, as well as those with an increased risk of cardiovascular issues. The drug was shown to improve the elimination of excess fluid from the lungs, reduce congestion, and shorten hospital stays for patients admitted for acute heart failure. The study demonstrated the safety and effectiveness of initiating dapagliflozin treatment within the first day of hospitalization for acute heart failure, according to Zachary Cox, PharmD, who is the first author of the paper.mains uncertain. Researchers at Lipscomb University are conducting a study to determine the most effective diuretic treatment for patients with acute heart failure. The study, which is expected to have a global impact on the treatment of this condition, aims to improve the care and outcomes of the 800,000 patients who are admitted to U.S. hospitals from emergency rooms each year. These patients are at high risk for prolonged hospital stays and death, and the annual cost of treating acute heart failure in the United States exceeds $34 billion. Currently, diuretics are the primary treatment for improving symptoms and lung congestion caused by fluid buildup in these patients, but the optimal approach to diuretic therapy remains uncertain.Poorly defined congestion can lead to prolonged hospital stays, high death rates, and frequent readmissions. Additionally, many patients do not respond well to diuretics, and approximately half of them leave the hospital still experiencing congestion. This often results in patients returning to the hospital shortly after discharge and being readmitted for further heart failure treatment. Dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, is being studied in a clinical trial at VUMC as a potential treatment for this issue.The research was conducted on patients suffering from acute heart failure. The study was led by JoAnn Lindenfeld, MD, and Sean Collins, MD, MSc, along with Cox, a member of VUMC’s heart failure research team. Lindenfeld, a renowned professor of Medicine in the Division of Cardiology, is recognized nationwide for her groundbreaking work in the field of heart failure. Collins, who is a professor of Emergency Medicine, is responsible for directing the Center for Emergency Care Research and Innovation (CERI) and is also involved in clinical trials research at VUMC.The Vanderbilt Institute for Medicine and Public Health is where Cox is a fellow of the Heart Failure Society of America. Cox has extensive publications in the field. Despite the COVID-19 pandemic, the researchers were able to enroll 240 patients and complete the trial. Cox attributed this success to the diligent effort and collaboration between the CERI research team, the departments of emergency medicine and cardiology. Cox also mentioned that this unique partnership allows VUMC to conduct trials in acute heart failure that are only possible in a small number of medical centers.He said that they have a great Emergency Medicine infrastructure and are leading in conducting important clinical trials. Patients were enrolled at various sites in addition to VUMC: TriStar Centennial Medical Center, Ascension St. Thomas Hospital West, University of North Carolina at Chapel Hill, University of Mississippi Medical Center, and INTEGRIS Health Baptist Medical Center. Patients were randomly selected within 24 hours of admission for acute heart failure.provide immediate treatment and set up patients for success after they leave the hospital,” said Dr. Adie Vilagut, lead researcher on the study. “The results show that dapagliflozin is a promising option for managing acute heart failure in hospitalized patients.”
The study’s findings were presented at the American College of Cardiology’s 70th Annual Scientific Session, and the researchers believe that early initiation of dapagliflozin could have significant impacts on patient outcomes and healthcare costs. “This could be a game-changer for how we approach acute heart failure and could potentially improve the lives of many patients,” Dr. Vilagut added.
“By enhancing diuresis and initiating Guideline Directed Medical Therapy early in patients with acute heart failure, we can make significant improvements,” Lindenfeld expressed. Additional VUMC co-authors include Cathy Jenkins, MS, Frank Harrell Jr., PhD from the Department of Biostatistics, as well as Christina Kampe, MAcc, Karen Miller, RN, MPA, and William Stubblefield, MD, MPH from the Department of Emergency Medicine. The study was financially supported by AstraZeneca but carried out independently by VUMC investigators. Dapagliflozin, marketed as FARXIGA, was the focus of the investigator-initiated trial. VUMC’s acute heart failure research is partly funded by the National Heart, Lung, and Blood Institute
