Evidence mapPaperPMID 40194974Full record

SynthesisJournal of the American Heart Association2025

Early Initiation of Sodium-Glucose Cotransporter 2 Inhibitors in Acute Heart Failure: A Systematic Review and Meta-Analysis.

Miloud Cherbi, Olivier Lairez, Guillaume Baudry, Paul Gautier, François Roubille, Clément Delmas

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Evolving Decongestion Strategies in the Management of Acute Heart Failure.Current treatment options in cardiovascular medicine · 2025
    Review
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

6 authors.

Miloud CherbiIntensive Cardiac Care Unit Université Paul Sabatier - Toulouse III Toulouse France.ORCID 0009-0004-8952-6283
Olivier LairezIntensive Cardiac Care Unit Université Paul Sabatier - Toulouse III Toulouse France.ORCID 0000-0001-8141-6582
Guillaume BaudryUniversité de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et des Vaisseaux Nancy France.ORCID 0000-0002-9200-2729
Paul GautierIntensive Cardiac Care Unit Université Paul Sabatier - Toulouse III Toulouse France.ORCID 0009-0008-9934-8432
François RoubilleCardiology Department Arnaud-De-Villeneuve Hospital Montpellier France.ORCID 0000-0002-5288-9687
Clément DelmasIntensive Cardiac Care Unit Université Paul Sabatier - Toulouse III Toulouse France.ORCID 0000-0001-9180-9128

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Heart FailureSodium-Glucose Transporter 2 InhibitorsTime-to-TreatmentAcute DiseaseHumansPatient ReadmissionRandomized Controlled Trials as TopicTime FactorsTreatment OutcomeSodium-Glucose Transporter 2 Inhibitorsacute heart failuredeathprognosissodium–glucose cotransporter 2 inhibitors

Identifiers

PMID40194974
PMCPMC12132883

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.