Real-World Evidence on the Use of SGLT2 Inhibitors in Elderly Patients with Acute Heart Failure

INTRODUCTION Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) have proven effective in chronic heart failure (CHF). However, evidence regarding their use in acute heart failure (AHF), particularly among elderly patients, is limited. This study aimed to assess the safety and tolerability of SGLT-2i in elderly patients hospitalized for AHF. METHODS We conducted a multicenter retrospective study including 192 patients admitted with AHF, with a mean age of 83.3 ± 8.3 years, of whom 57.3% were female. The initiation of SGLT-2i during hospitalization, adverse events, mortality, and readmission rates were analyzed. RESULTS SGLT-2i therapy was initiated within the first 48 hours of admission in 31.3% of patients. Only 5.7% experienced drug-related adverse effects. During follow-up, 10.4% of patients died and 25% required hospital readmission. CONCLUSIONS SGLT-2i treatment in elderly patients with AHF demonstrated good tolerance and safety, even in those with multiple comorbidities. These findings suggest that early initiation of SGLT-2i during hospitalization for AHF may represent an effective and safe therapeutic strategy, supporting the optimization of clinical management in this high-risk population.