Heart failure & cardiomyopathiesCohort study
Sodium-Glucose Cotransporter 2 Inhibitor Use for Heart Failure in US Ambulatory Cardiovascular Care
- Retrospective cohort study
- registry-based
- national
Authors' conclusion
Although this study found that SGLT2i use had increased among ambulatory patients with HF during the study period, the majority of eligible patients did not receive this therapy. Older age, female sex, and higher blood pressures were associated with lower SGLT2i use with significant unexplained variation in use across practices.
Study context
- Population
- Patients with heart failure (HF) in US ambulatory CV care (National Cardiovascular Data Registry (NCDR) Practice Innovation and Clinical Excellence (PINNACLE) registry), July 2019–June 2023
- Participants
- 759,915 patients · 191 US sites
- Exposure
- HF with Reduced EF (HFrEF) vs HF with Mildly Reduced EF (HFmrEF) or HF with Preserved EF (HFpEF)
- Outcome
- Patient-level and practice-level prescription of SGLT2i therapy
Main finding
As reported in the abstract
SGLT2i prescription
Observational data: associations, not effects.
Further findings
Trend in SGLT2i use, Q3 2019 to Q2 2023
- All HF: 4.6% to 16.2%
- P for trend < 0.001
- HFrEF: 5.1% to 28.5%
- P for trend < 0.001
- HFmrEF or HFpEF: 4.5% to 12.8%
- P for trend < 0.001
Factors associated with SGLT2i use
- Older age (IQR age, 80 vs 63 years): OR
- 0.76 (95% CI 0.75-0.77)
- Female sex: OR
- 0.79 (95% CI 0.77-0.81)
- Higher SBP: OR
- 0.78 (95% CI 0.77-0.79)
- History of T2DM: OR
- 3.21 (95% CI 3.15-3.28)
Site-level variation in SGLT2i use (adjusted)
- 90th vs 10th percentile risk practice: adjusted OR
- 4.40 (95% CI 3.76-5.52)
- adjusted for patient- and practice-level characteristics
Original publication
Sodium-Glucose Cotransporter 2 Inhibitor Use for Heart Failure in US Ambulatory Cardiovascular Care. JAMA Cardiol. Published 1 September 2025. doi:10.1001/jamacardio.2025.2145
Summarised from the published abstract; every number is checked against it