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

Publication ,  Journal Article
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 ...
Published in: J Am Coll Cardiol
November 16, 2021

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.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

November 16, 2021

Volume

78

Issue

20

Start / End Page

2004 / 2012

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Stroke Volume
  • Sodium-Glucose Transporter 2 Inhibitors
  • Risk
  • Randomized Controlled Trials as Topic
  • Practice Guidelines as Topic
  • Patient-Centered Care
  • Patient Readmission
  • Patient Discharge
  • Hypoglycemic Agents
 

Citation

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Rao, V. N., Murray, E., Butler, J., Cooper, L. B., Cox, Z. L., Fiuzat, M., … Greene, S. J. (2021). In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol, 78(20), 2004–2012. https://doi.org/10.1016/j.jacc.2021.08.064
Rao, Vishal N., Evan Murray, Javed Butler, Lauren B. Cooper, Zachary L. Cox, Mona Fiuzat, Jennifer B. Green, et al. “In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure With Reduced Ejection Fraction.J Am Coll Cardiol 78, no. 20 (November 16, 2021): 2004–12. https://doi.org/10.1016/j.jacc.2021.08.064.
Rao VN, Murray E, Butler J, Cooper LB, Cox ZL, Fiuzat M, et al. In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol. 2021 Nov 16;78(20):2004–12.
Rao, Vishal N., et al. “In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure With Reduced Ejection Fraction.J Am Coll Cardiol, vol. 78, no. 20, Nov. 2021, pp. 2004–12. Pubmed, doi:10.1016/j.jacc.2021.08.064.
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. In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors for Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol. 2021 Nov 16;78(20):2004–2012.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

November 16, 2021

Volume

78

Issue

20

Start / End Page

2004 / 2012

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Stroke Volume
  • Sodium-Glucose Transporter 2 Inhibitors
  • Risk
  • Randomized Controlled Trials as Topic
  • Practice Guidelines as Topic
  • Patient-Centered Care
  • Patient Readmission
  • Patient Discharge
  • Hypoglycemic Agents