Heart failure & cardiomyopathiesCohort study
Early Adoption of Sodium-Glucose Cotransporter-2 Inhibitor in Patients Hospitalized With Heart Failure With Mildly Reduced or Preserved Ejection Fraction
- Retrospective cohort study
- registry-based
- 557 US sites
Authors' conclusion
For patients with HF and an LVEF greater than 40%, discharge prescription of SGLT2is increased from 4.2% to 23.5% during the first 2 years after the EMPEROR-Preserved trial demonstrating treatment benefits; however, these rates varied across US hospitals.
Study context
- Population
- Patients hospitalised for decompensated heart failure (HF) with left ventricular ejection fraction (LVEF) >40%, Get With The Guidelines-Heart Failure registry, 557 US sites, July 2021–September 2023
- Participants
- 158,849 patients
- Exposure
- Mildly reduced LVEF vs Preserved LVEF
- Mildly reduced LVEFn = 27,712
- Preserved LVEFn = 131,137reference
- Outcome
- Patient-level trends and site-level variation in SGLT2i prescription rates at hospital discharge (site variation as median OR)
- Follow-up
- Hospital discharge
Main finding
SGLT2i prescription at discharge
Absolute standardized difference
16.7%
Events by group
As reported in the abstract
- Overall SGLT2i prescription at discharge
- 22 126 (13.9%)
- Quarterly prescription rate, July–September 2021
- 4.2%
- Quarterly prescription rate, July–September 2023
- 23.5%
- Trend in quarterly prescription rates
- P for trend < 0.001
- Between-hospital variation, adjusted median OR
- 2.12 (95% CI 2.02-2.25)
- Hospitals (of 518 with ≥10 eligible discharges) discharging ≥50% with SGLT2i
- 11 (2.1%)
- Hospitals (of 518) discharging <10% with SGLT2i
- 232 (44.8%)
Observational data: associations, not effects.
Original publication
Early Adoption of Sodium-Glucose Cotransporter-2 Inhibitor in Patients Hospitalized With Heart Failure With Mildly Reduced or Preserved Ejection Fraction. JAMA Cardiol. Published 1 January 2025. doi:10.1001/jamacardio.2024.4489
Summarised from the published abstract; every number is checked against it