SynthesisJournal of the American Heart Association2025
Early Initiation of Sodium-Glucose Cotransporter 2 Inhibitors in Acute Heart Failure: A Systematic Review and Meta-Analysis.
Synthesis in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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.
Who cites it
3 citing papers in PubMed.
- Utilization Patterns and Barriers to Sodium-Glucose Cotransporter-2 Inhibitor Prescription in Patients with Heart Failure: Real-World Evidence from Saudi Arabia.Cardiology and therapy · 2026Article
- Next-Generation SGLT2 Inhibitors: Innovations and Clinical Perspectives.Biomedicines · 2025Review
- Evolving Decongestion Strategies in the Management of Acute Heart Failure.Current treatment options in cardiovascular medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObservational studies and small randomized controlled trials have suggested the benefits of early introduction of sodium-glucose cotransporter 2 inhibitors (SGLT2is) in acute heart failure (AHF). However, current evidence on their efficacy and safety in this clinical setting remains limited.
methodsWe performed a systematic review and meta-analysis to assess efficacy/safety of early use of SGLT2is in AHF. PUBMED/EMBASE/Cochrane were searched from inception to May 31, 2024, for randomized controlled trials evaluating outcomes of SGLT2i early initiation in patients with AHF. Efficacy outcomes were all-cause death and heart failure rehospitalizations. Safety outcomes included acute kidney injury, ketoacidosis, urinary tract infections, hypotension, and hypoglycemia. Early initiation was defined as performed before or shortly after discharge (within 3 days). A sensitivity analysis was conducted, including only patients with initiation before discharge.
resultsSeven randomized controlled trials that enrolled 2320 patients were included. Early use of SGLT2is was associated with a significant reduction in all-cause death (odds ratio, 0.71 [95% CI, 0.55-0.92; 95% PI, 0.55-0.98]) and HF rehospitalizations (odds ratio, 0.73 [95% CI, 0.57-0.94; 95% PI, 0.58-0.93]), even after adjusting for follow-up duration. SGLT2i initiation before discharge yielded consistent results for efficacy outcomes. Safety outcomes could not be usefully determined because of a low events rate resulting in wide CIs. The impact of diabetic status remains basically unknown due to the small number of available randomized controlled trials investigating this population.
conclusionsEarly introduction of SGLT2is in AHF improves all-cause death and rehospitalization rates, can be performed before discharge, and should be offered to most patients with AHF.
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Registered trials
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.