In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure With Reduced Ejection Fraction.

Journal Article (Journal Article;Review)

Sodium-glucose cotransporter-2 inhibitor therapy is well suited for initiation during the heart failure hospitalization, owing to clinical benefits that accrue rapidly within days to weeks, a strong safety and tolerability profile, minimal to no effects on blood pressure, and no excess risk of adverse kidney events. There is no evidence to suggest that deferring initiation to the outpatient setting accomplishes anything beneficial. Instead, there is compelling evidence that deferring in-hospital initiation exposes patients to excess risk of early postdischarge clinical worsening and death. Lessons from other heart failure with reduced ejection fraction therapies highlight that deferring initiation of guideline-recommended medications to the U.S. outpatient setting carries a >75% chance they will not be initiated within the next year. Recognizing that 1 in 4 patients hospitalized for worsening heart failure die or are readmitted within 30 days, clinicians should embrace the in-hospital period as an optimal time to initiate sodium-glucose cotransporter-2 inhibitor therapy and treat this population with the urgency it deserves.

Full Text

Duke Authors

Cited Authors

  • Rao, VN; Murray, E; Butler, J; Cooper, LB; Cox, ZL; Fiuzat, M; Green, JB; Lindenfeld, J; McGuire, DK; Nassif, ME; O'Brien, C; Pagidipati, N; Sharma, K; Vaduganathan, M; Vardeny, O; Fonarow, GC; Mentz, RJ; Greene, SJ

Published Date

  • November 16, 2021

Published In

Volume / Issue

  • 78 / 20

Start / End Page

  • 2004 - 2012

PubMed ID

  • 34763778

Pubmed Central ID

  • PMC9766421

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2021.08.064


  • eng

Conference Location

  • United States