Early initiation of SGLT2 inhibitors during hospitalization for acute heart failure significantly reduced all-cause mortality by 37% (RR 0.63) compared to standard care.
Meta-Analysis (n=3,596)
Yes
Does early initiation of SGLT2 inhibitors reduce all-cause mortality or heart failure hospitalization in patients hospitalized for acute heart failure?
Early initiation of SGLT2 inhibitors during hospitalization for acute heart failure safely reduces all-cause mortality without increasing adverse events.
Effect estimate: RR 0.63 (95% CI 0.46-0.85)
Absolute Event Rate: 3.36% vs 5.23%
p-value: p=0.003
This systematic review and meta-analysis of 8 randomized controlled trials (3,596 patients) evaluated the effects of starting Sodium-glucose cotransporter-2 inhibitors (SGLT2i, dapagliflozin or empagliflozin) during hospitalization for acute heart failure (AHF).Early initiation of SGLT2i significantly reduced all-cause mortality (risk ratio, 0.63) without increasing the risk of adverse events such as hypotension, hypoglycemia, acute kidney injury, or ketoacidosis.However, no significant effect was observed on heart failure hospitalization.Overall, the findings support the safety and survival benefits of early SGLT2i use in AHF, though more research is needed to confirm effects on rehospitalization outcomes.
Mata et al. (Thu,) conducted a meta-analysis in Acute heart failure (n=3,596). Sodium-glucose cotransporter-2 inhibitors (dapagliflozin or empagliflozin) vs. Placebo or optimized medical therapy alone was evaluated on All-cause mortality (RR 0.63, 95% CI 0.46-0.85, p=0.003). Early initiation of SGLT2 inhibitors during hospitalization for acute heart failure significantly reduced all-cause mortality by 37% (RR 0.63) compared to standard care.