Heart failure & cardiomyopathiesCohort study
Implementation of sodium-glucose co-transporter 2 inhibitors use in patients with heart failure across the ejection fraction: data from the Swedish heart failure registry
- real-world heart failure (HF) cohort
- Swedish HF Registry
- multivariable logistic regression models
Authors' conclusion
SGLT2i were rapidly implemented in clinical practice, with their use reaching ∼90% in HFrEF and approaching a plateau at ∼80% in HFmrEF and HFpEF in December 2024. There is still room for treatment optimization, particularly among women, patients with HFpEF without T2DM, those followed in primary care, and with lower socioeconomic status.
Study context
- Population
- Patients with heart failure across the ejection fraction from the Swedish HF Registry enrolled 1 September 2022 to 16 December 2024median age [Q1-Q3]:75 [65–81] years, 33% female
- Participants
- 24,578 patients
- Exposure
- Characteristics independently associated with SGLT2i use, in the overall cohort and stratified by ejection fraction (EF)
Main finding
As reported in the abstract
Distribution of EF categories
Observational data: associations, not effects.
Further findings
SGLT2i use · During the study period
start
end
Independent predictors of SGLT2i use
- Independent predictors of SGLT2i use included male sex, HF hospitalization during the past year, impaired kidney function, obesity, higher socioeconomic profile, and beta-blocker use
- Follow-up in specialist care was associated with higher use in HF with reduced EF (HFrEF) and HF with mildly reduced EF (HFmrEF)
- Type 2 diabetes (T2DM) was independently associated with use across EF, with a stronger association in HF with preserved EF (HFpEF)
- Renin-angiotensin-aldosterone system inhibitors were associated with SGLT2i use across the EF spectrum, with stronger associations in HFrEF and HFmrEF
- mineralocorticoid receptor antagonists showed similar associations across EF categories, stronger in HFrEF and HFmrEF
Original publication
Implementation of sodium-glucose co-transporter 2 inhibitors use in patients with heart failure across the ejection fraction: data from the Swedish heart failure registry. Eur Heart J Qual Care Clin Outcomes. Published 19 April 2026. doi:10.1093/ehjqcco/qcag063
Summarised from the published abstract; every number is checked against it