SGLT2 Inhibitor Uptake Rises but Misses Highest-Risk HFrEF Patients
This single-system US cohort documents post-guideline in-hospital SGLT2 inhibitor uptake in heart failure with reduced ejection fraction and links initiation to lower 30-day readmission, while showing the signal is inseparable from bundled guideline-directed therapy optimization.
Heart failure has high readmission rates, impacting healthcare costs and patient outcomes. SGLT2 inhibitors are now recommended for HFrEF but real-world uptake and outcomes are unclear. In-hospital initiation of SGLT2 inhibitors significantly lowered 30-day readmissions in HFrEF (12.1% vs 31.8%), though confounding by co-prescribed treatments was noted. Despite promising reductions in readmissions, initiation was bundled with GDMT, obscuring individual effects. Findings are hypothesis-generating and highlight gaps in prescribing high-risk patients. In-hospital SGLT2 inhibitor initiation may reduce readmissions but requires further study to clarify benefits versus GDMT.
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Authors:Pulatov O, Kim SY, Grossman Z, Noor F, Salam B, Khan T, Matam A, Wang S, Caraccio T, Marzo KP
Citation:Pulatov O, Kim SY, Grossman Z, et al. In-hospital SGLT2 inhibitor initiation, prescribing gaps, and 30-day all-cause readmission in heart failure with reduced ejection fraction: a US post-guideline cohort study. BMC cardiovascular disorders. 2026. doi:10.1186/s12872-026-06184-y
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Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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