Evidence mapPaperPMID 41817874Full record

Observational studyClinical drug investigation2026

Determinants and Prognostic Impact of In-Hospital Sodium-Glucose Cotransporter-2 Inhibitor Initiation in Patients with Heart Failure.

Takuya Okamoto, Koichiro Matsumura, Shohei Hakozaki, Eijiro Yagi, Kazuyoshi Kakehi, Ayano Yoshida, Takayuki Kawamura, Kosuke Fujita, Masafumi Ueno, Kimiko Fujiwara and 2 more

Abstract readObservational Study
In one paragraph

Observational study in Clinical drug investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Takuya OkamotoDepartment of Pharmacy, Kindai University Hospital, Sakai, Japan.
Koichiro MatsumuraDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan. kmatsumura1980@yahoo.co.jp.ORCID http://orcid.org/0000-0002-9089-3505
Shohei HakozakiDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan.
Eijiro YagiDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan.
Kazuyoshi KakehiDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan.
Ayano YoshidaDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan.
Takayuki KawamuraDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan.
Kosuke FujitaDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan.
Masafumi UenoDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan.
Kimiko FujiwaraDepartment of Pharmacy, Kindai University Hospital, Sakai, Japan.
Manabu TakegamiDepartment of Pharmacy, Kindai University Hospital, Sakai, Japan.
Gaku NakazawaDepartment of Cardiology, Faculty of Medicine, Kindai University, 1-14-1 Miharadai, Minami-ku, Sakai, 5900197, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesInitiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients hospitalised for heart failure (HF) is crucial for improving long-term outcomes. However, in real-world practice, a considerable proportion of patients are discharged without initiation. This study aimed to evaluate the initiation rate of SGLT2i, identify clinical factors associated with non-initiation, and examine the impact on long-term prognosis in patients hospitalised for HF.

methodsThis single-centre, retrospective, observational analysis of a prospective registry included 781 consecutive patients who were hospitalised for HF between 2021 and 2024. The primary endpoint was the in-hospital initiation rate of SGLT2i. Secondary endpoints included clinical factors associated with non-initiation, assessed using multivariable logistic regression, and the incidence of the composite endpoint of all-cause mortality or HF rehospitalisation at 1 year according to SGLT2i prescription status at discharge, evaluated by log-rank test and Cox proportional hazards analysis.

resultsA total of 467 patients (median age 81 [74-87] years, 50.3% male) were included in the final analysis. The initiation rate of SGLT2i during hospitalisation was 37.3% (174/467), and treatment discontinuation after initiation occurred in 8.6% (15/174). Multivariable analysis revealed that older age, non-diabetes, impaired renal function, higher left ventricular ejection fraction, malnutrition, impaired mobility, and cognitive dysfunction were independently associated with non-initiation. Among 346 patients with available follow-up data, the incidence of the composite endpoint at 1 year was significantly higher in the non-initiation group than in the initiation group (37.5% vs 21.3%, log-rank p = 0.001). In multivariable Cox analysis, not prescribed SGLT2i at discharge remained independently associated with worse long-term outcomes (hazard ratio 1.70, 95% confidence interval 1.07-2.69, p = 0.02).

conclusionBoth conventional clinical factors (e.g., diabetes, left ventricular ejection fraction) and aging-related factors (e.g., nutritional status, mobility, cognitive function) were independently associated with non-initiation of SGLT2i in hospitalised patients with HF. Importantly, non-initiation at discharge was significantly associated with worse long-term outcomes, underscoring the need to promote active initiation of SGLT2i in this population.

Indexed as

Heart FailureSodium-Glucose Transporter 2 InhibitorsAgedAged, 80 and overFemaleHospitalizationHumansMalePrognosisRegistriesRetrospective StudiesSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID41817874
PMCPMC13102791

What Socratic holds

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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.