Contemporary Use of Sodium-Glucose Cotransporter-2 Inhibitor Therapy Among Patients Hospitalized for Heart Failure With Reduced Ejection Fraction in the US
Key result
Only ~20% of hospitalized HFrEF patients receive SGLT2i at discharge amid significant hospital variation.
Why the study?
Clinical guidelines strongly recommend SGLT2 inhibitors for HFrEF, but nationwide adoption in the US was unknown.
Population
49 399 patients hospitalized for HFrEF across 489 sites in the US GWTG-HF registry
Comparison
Prescription vs non-prescription of SGLT2i at hospital discharge
Design
Retrospective cohort study
Authors
Discussion
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Member takes
Implication
Low SGLT2i uptake with marked hospital variation signals an implementation gap in HFrEF; leaves open the need for targeted strategies and prospective trials.
Structured PICO
P
Population
49,399 patients hospitalized for heart failure with reduced ejection fraction (HFrEF) across 489 sites in the US Get With The Guidelines–Heart Failure (GWTG-HF) registry. Median age 67, 33.5% female. Key exclusions: estimated glomerular filtration rate <20 mL/min/1.73 m2, type 1 diabetes, and previous intolerance to SGLT2i.
I
Intervention
Prescription of sodium-glucose cotransporter-2 inhibitor (SGLT2i) at hospital discharge
O
Outcome
Patient-level and hospital-level prescription of SGLT2i at hospital discharge
Despite strong guideline recommendations, only 20.2% of eligible US patients hospitalized for HFrEF are prescribed an SGLT2i at discharge, highlighting a significant gap in guideline-directed medical therapy implementation.
Cite This Study
Pierce et al. (2023) studied this question. Only 20.2% of hospitalized HFrEF patients were prescribed SGLT2 inhibitors at discharge, with significant variation across hospitals (median odds ratio 2.51).