When should we consider SGLT-2 inhibitors in patients with acute decompensated heart failure?

When should we consider SGLT-2 inhibitors in patients with acute decompensated heart failure? Q:Sodium-glucose cotransporter 2 (SGLT-2) inhibitors should be started as early as possible in patients hospitalized with acute decompensated heart failure who do not have clear contraindications to them, and continued after discharge (Figure 1).These medications are well tolerated, can aid in decongestion without worsening renal function, and have multiple cardiovascular benefi ts.[5] ■ BENEFITS OF STARTING EARLY Acute decompensated heart failure is one of the leading reasons for hospital admissions worldwide and is associated with considerable morbidity and mortality. 6s outlined below and in Table 1, 3,4,[7][8][9][10][11] studies have suggested that patients hospitalized for acute decompensated heart failure could tolerate SGLT-2 inhibitors and derive cardiac benefi t from them, especially when these drugs were started early.While most of the patients in these trials had reduced left ventricular ejection fraction, the benefi ts were consistent across all left-ventricular-ejection-fraction groups.