Heart failure & cardiomyopathiesCohort study
Longitudinal loop diuretic use in patients with HF with reduced ejection fraction (HFrEF) initiated with sodium–glucose cotransporter 2 inhibitors
- real-world heart failure (HF) cohort
- unselected
- SwedeHF
Authors' conclusion
In this real-world population with HFrEF, SGLT2i initiation was associated with a decrease in loop diuretic need at 1-year follow-up.
Study context
- Population
- Patients with HF with reduced ejection fraction (HFrEF) enrolled in the SwedeHF between January 2020 and October 20215,623 (81.6%) controls and 1265 (18.4%) cases were analysed · controls 5,623 · cases 1,265
- Participants
- 1,265 vs 5,623
- Exposure
- cases vs controls
- casesn = 1,265
- controlsn = 5,623
Main finding
Loop diuretic withdrawal/dose reduction · 1-year follow-up
Difference between proportions
6%
CI 3%–9%
<0.001
SGLT2i users vs controls
difference between proportions 6% (CI 3%–9%); <0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | difference between proportions (CI) | P value | |
|---|---|---|---|
| Loop diuretic initiation or dose increase · 1-year follow-up · less likely with SGLT2i users | −5% (−7% to −3%) | <0.001 | |
| −10−505Difference (linear scale) |
| Outcome | adjusted mean difference between groups (mg) (CI) | P value | |
|---|---|---|---|
| Net change in furosemide-equivalent daily doses · 1-year follow-up · more accentuated net decrease with SGLT2i users | −4.2 (−7 to −1.5) | 0.002 | |
| −10−505Difference, mg (linear scale) |
Decrease in loop diuretic doses/withdrawn after SGLT2i initiation
| Comparison | adjusted OR (CI) | P value | |
|---|---|---|---|
| SGLT2i initiation · multivariable regression model | 1.58 (1.35–1.85) | ||
| 0.512Adjusted odds ratio (log scale) |
Increase in loop diuretic doses/new initiation
| Comparison | adjusted OR (CI) | P value | |
|---|---|---|---|
| SGLT2i initiation · multivariable regression model | 0.50 (0.38–0.64) | ||
| 0.20.5125Adjusted odds ratio (log scale) |
Baseline loop diuretic prescription
- patients prescribed with loop diuretics
- 5224 (75.8%)
- mean (SD) furosemide-equivalent dose
- 36.7 (27.4) mg
Original publication
Longitudinal loop diuretic use in patients with HFrEF initiated with sodium–glucose cotransporter 2 inhibitors. Eur Heart J Cardiovasc Pharmacother. Published 10 June 2026. doi:10.1093/ehjcvp/pvag041
Summarised from the published abstract; every number is checked against it