Key result
Discharge SGLT2i in older HFrEF patients linked to ~24% lower 12-month mortality and fewer HF readmissions.
Why the study?
Randomized trials of SGLT2 inhibitors in HFrEF enrolled relatively younger outpatients, leaving their effectiveness in older patients hospitalized for HFrEF in routine US clinical practice not well studied.
Does SGLT2 inhibitor initiation by hospital discharge reduce mortality and readmissions in older patients hospitalized for HFrEF?
Population
8847 Medicare beneficiaries aged ≥65 years hospitalized for HFrEF
Comparison
SGLT2i initiation by discharge vs not prescribed SGLT2i
Design
Registry-based observational study with propensity score overlap weighting
Follow-up
12-month
Authors
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Supports early SGLT2i initiation at discharge in older HFrEF; extends trial data to Medicare patients while leaving causality open.
Observational (n=8,847)
Yes
Does SGLT2 inhibitor initiation by hospital discharge reduce mortality and readmissions in older patients hospitalized for HFrEF?
Effect estimate: HR 0.76 (95% CI 0.67-0.86)
Initiation of SGLT2 inhibitors by hospital discharge in older, real-world Medicare patients with HFrEF is associated with significantly reduced 1-year all-cause mortality and readmissions.
Brownell et al. (2026) conducted an observational in Heart Failure with Reduced Ejection Fraction (HFrEF) (n=8,847). SGLT2 inhibitors vs. Not prescribed SGLT2 inhibitors was evaluated on 30-day and 1-year all-cause mortality, all-cause readmission, and HF readmission (HR 0.76, 95% CI 0.67-0.86). SGLT2i initiation by discharge among older patients hospitalized for HFrEF was associated with lower 12-month all-cause mortality (HR 0.76; 95% CI 0.67-0.86) and HF readmission (HR 0.84).
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