Evidence map›Paper›PMID 39267410›Full record

ArticleEuropean journal of heart failure2025

Timing of sodium-glucose cotransporter 2 inhibitor initiation and post-discharge outcomes in acute heart failure with diabetes: A population-based cohort study.

Che-Yuan Wu, Baiju R Shah, Abhinav Sharma, Yiru Sheng, Peter P Liu, Alexander Kopp, Refik Saskin, Jodi D Edwards, Walter Swardfager

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In one paragraph

Article in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Che-Yuan WuDepartment of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
Baiju R ShahICES, Toronto, ON, Canada.
Abhinav SharmaDivision of Cardiology, McGill University Health Centre, McGill University, Montreal, QC, Canada.
Yiru ShengICES, Toronto, ON, Canada.
Peter P LiuUniversity of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada.
Alexander KoppICES, Toronto, ON, Canada.
Refik SaskinICES, Toronto, ON, Canada.
Jodi D EdwardsUniversity of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada.
Walter SwardfagerDepartment of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-0030-8908

Funding

Canada First Research Excellence Fund, Heart-Brain Connection BHRIITE IMPACT AwardCanada Research Chairs CRC-2020-00353CIHR 202111FBD-47623-75801Heart and Stroke Foundation of Canada, Heart-Brain Connection BHRIITE IMPACT AwardMinistry of Colleges and Universities ER21-16-141Temerty Faculty of Medicine, University of Toronto, Novo Nordisk Research Chair in Equitable Care of Diabetes and Related Conditions
6 · The paper itself

Abstract

aimsResults from randomized trials suggest benefit of sodium-glucose cotransporter 2 (SGLT2) inhibitor initiation in clinically stable acute heart failure. We aim to examine the real-world effectiveness of early versus delayed post-discharge SGLT2 inhibitor initiation in people with acute heart failure and type 2 diabetes. METHODS AND

resultsUsing linkable administrative databases in Ontario, Canada, individuals aged 66 years or older with type 2 diabetes who were discharged to the community from acute care hospitals for heart failure between 1 July 2016 and 31 March 2020 were included in this retrospective, population-based cohort study. The primary outcome was hospitalization for heart failure (HHF) or cardiovascular mortality as a composite. Follow-up started from discharge for maximum 1 year. We compared outcomes between post-discharge SGLT2 inhibitor initiation within 3 days, 4-90 days, or 91-180 days, versus delayed initiation for at least 180 days. The 'clone-censor-weight' approach with a target trial emulation framework was used to address time-related biases. There were 9641 eligible individuals. After cloning and artificial censoring, there were 38 564 clones, 12 439 person-years, and 7584 events. Compared to delayed initiation for at least 180 days, initiation within 3 days post-discharge was associated with a lower 1-year risk of HHF or cardiovascular mortality (risk ratio [RR] 0.65, 95% confidence interval [CI] 0.45-0.83), while initiation 4-90 days (RR 0.83, 95% CI 0.72-0.93) or 91-180 days (RR 0.89, 95% CI 0.79-0.97) showed smaller risk reduction.

conclusionReal-world evidence supports early SGLT2 inhibitor initiation to reduce HHF or cardiovascular mortality in acute heart failure and type 2 diabetes.

Indexed as

Diabetes Mellitus, Type 2Heart FailurePatient DischargeSodium-Glucose Transporter 2 InhibitorsAcute DiseaseAgedFemaleFollow-Up StudiesHospitalizationHumansMaleOntarioRetrospective StudiesTime FactorsTreatment OutcomeSodium-Glucose Transporter 2 InhibitorsAcute heart failureDiabetesPharmacoepidemiologySGLT2 inhibitor

Identifiers

PMID39267410
PMCPMC11860729

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.