{"id":"117b2521339d","type":"article","url":"https://hartvaat.nl/2026/10/01/sglt2-remmers-bij-zeer-oude-hartfalenpatienten-nierfunctie-en-palliatieve-zorg-b/","title":"SGLT2-remmers bij zeer oude hartfalenpatiënten: nierfunctie en palliatieve zorg bepalen voorschrijfpatroon","title_en":"SGLT2 inhibitor prescription at discharge in very old adults with heart failure irrespective of diabetes status.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"International journal of cardiology. Heart & vasculature","doi":"10.1016/j.ijcha.2026.101980","source_url":"https://doi.org/10.1016/j.ijcha.2026.101980","authors":["Rémi Esser","Marc Harboun","Marine Larbaneix","Alejandro Mondragon","Sophie Balesdent","Marlène Esteban","Jennifer Corny","Christine Farges","Vincenzo Palermo","Nicolas Pages","Sophie Nisse Durgeat","Olivier Maurou"],"significance":4,"published":"2026-08-15","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/","https://hartvaat.nl/kennis/hartfalen/arni-sacubitril-valsartan/"],"congress":"","summary_en":"A single-centre retrospective study of 1,235 hospitalisations in a cardiogeriatric unit found that SGLT2 inhibitors were prescribed at discharge in 82.3% of very old heart failure patients (median age 88.6 years), regardless of diabetes status. Non-prescription was strongly associated with advanced chronic kidney disease (CKD stages 4–5) and palliative care orientation, but not with age or comorbidity burden. These patterns highlight that renal function and care goals, rather than diabetes or frailty alone, currently drive SGLT2 inhibitor use in this vulnerable population, informing discharge prescribing decisions.","created":"2026-08-09T01:00:21Z","updated":"2026-08-10T10:35:30Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve studie onder 1.235 opnames in een cardiogeriatrische eenheid toont dat SGLT2-remmers bij 82,3% van zeer oude hartfalenpatiënten (median 88,6 jaar) op de ontslagrecept staat, ongeacht diabetesstatus. Niet-voorschrijven hing sterk samen met ernstige nierfunctiestoornis (CKD 4/5) en palliatieve zorgoriëntatie, maar niet met leeftijd of comorbiditeit. Deze bevindingen benadrukken dat nierfunctie en zorgdoelstelling de belangrijkste bepalers zijn van SGLT2-remmergebruik in deze kwetsbare groep, wat hulpverleners kan helpen bij het afwegen van indicaties bij ontslag.","abstract_original":"BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended across the heart failure (HF) spectrum, irrespective of diabetes status. However, prescribing patterns in very old adults with multimorbidity, renal dysfunction, and geriatric vulnerability remain insufficiently characterised. METHODS: We conducted a single-centre retrospective cross-sectional study in a specialised acute cardiogeriatric unit between January 1, 2025, and February 13, 2026. Consecutive hospitalisations with confirmed HF and documented SGLT2i discharge status were included. The primary outcome was absence of SGLT2i at discharge. Multivariable logistic regression identified factors independently associated with non-prescription. RESULTS: Among 1235 hospitalisations, median age was 88.6 years [IQR 82-92], 54.5% were women, and 32.7% had diabetes. SGLT2i were prescribed in 1016 hospitalisations (82.3%) and absent in 219 (17.7%). Prescription did not differ by diabetes status (80.4% vs 83.2%, p = 0.276) or across HbA1c tertiles. In the prespecified primary model, non-prescription was associated with CKD stage 4 (aOR 2.79 [95% CI 1.97-3.96]), CKD stage 5 (aOR 20.29 [9.67-42.56]), palliative orientation (aOR 1.62 [1.09-2.41]), and HFrEF versus HFpEF (aOR 1.55 [1.08-2.22]). Higher albumin and medication count were associated with lower odds of non-prescription. Diabetes, age, and Charlson Comorbidity Index were not independently associated with the primary outcome. CONCLUSION: SGLT2i prescription was frequent and similar according to diabetes status and glycaemic control. Advanced CKD and palliative-oriented care were the most consistent correlates of non-prescription. These findings describe prescribing patterns but do not establish the appropriateness of individual decisions."}