Heart failure & cardiomyopathiesCohort study
Real-world data on early initiation of sodium-glucose co-transporter-2 inhibitors in newly diagnosed heart failure with reduced ejection fraction
- retrospective analysis
- TriNetX Global Collaborative research network
- propensity score matching
Authors' conclusion
In this large multinational real-world data of patients with HFrEF, the prescription rate for SGLT2is within 6 weeks after the first HF hospitalization remained low. However, SGLT2i initiation was associated with improved outcomes, underscoring the importance of guideline-recommended early use.
Study context
- Population
- Patients with HF and reduced ejection fraction (HFrEF) who experienced their first heart failure (HF) hospitalization between September 2021 and December 2023patients with HFrEF identified, 14,670 matched pairs after matching
- Participants
- 70,042 patients
- Exposure
- Sodium-glucose cotransporter-2 inhibitor users vs non-users
Main finding
As reported in the abstract
Prescription rate of SGLT2is within 6 weeks following first HF hospitalization · within 6 weeks
Initiated on SGLT2is within 6 weeks following their first HF hospitalization
21.3%
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause mortality · 1 year · lower risk with SGLT2i users; matched · after propensity score matching | 0.75 (0.69–0.83) | |
| All-cause hospitalizations · 1 year · lower risk with SGLT2i users; matched | 0.86 (0.83–0.91) | |
| Emergency department visits · 1 year · lower risk with SGLT2i users; matched | 0.91 (0.86–0.96) | |
| 0.512Hazard ratio (log scale) |
Baseline characteristics before matching
- SGLT2i users were younger, more likely to be male, and had a higher prevalence of diabetes, compared with SGLT2i non-users
Matched cohort characteristics
- matched pairs
- 14 670
- mean age
- 64 ± 17 years
- female
- 41.6%
- Black
- 20%
Original publication
Real-world data on early initiation of sodium-glucose co-transporter-2 inhibitors in newly diagnosed heart failure with reduced ejection fraction. ESC Heart Fail. Published 17 February 2026. doi:10.1093/eschf/xvag008
Summarised from the published abstract; every number is checked against it