Evidence map›Paper›PMID 34763778›Full record

ReviewJournal of the American College of Cardiology2021

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

Vishal N Rao, Evan Murray, Javed Butler, Lauren B Cooper, Zachary L Cox, Mona Fiuzat, Jennifer B Green, JoAnn Lindenfeld, Darren K McGuire, Michael E Nassif and 8 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of the American College of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  8. Observational
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  19. The use of SGLT2 inhibitors in older people: What is important?Aging clinical and experimental research · 2025
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Vishal N RaoDivision of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Evan MurrayDuke University School of Medicine, Durham, North Carolina, USA.
Javed ButlerDepartment of Medicine, University of Mississippi, Jackson, Mississippi, USA.
Lauren B CooperDepartment of Cardiology, North Shore University Hospital, Manhasset, New York, USA.
Zachary L CoxDepartment of Pharmacy, Vanderbilt University Medical Center, Nashville Tennessee, USA.
Mona FiuzatDuke Clinical Research Institute, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA.
Jennifer B GreenDuke Clinical Research Institute, Durham, North Carolina, USA; Division of Endocrinology, Duke University School of Medicine, Durham, North Carolina, USA.
JoAnn LindenfeldDivision of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Darren K McGuireDivision of Cardiology, University of Texas Southwestern Medical Center and Parkland Health and Hospital System, Dallas, Texas, USA.
Michael E NassifSaint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA.
Cara O'BrienDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Neha PagidipatiDivision of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Kavita SharmaDivision of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Muthiah VaduganathanHeart and Vascular Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Orly VardenyCenter for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, and University of Minnesota, Minneapolis, Minnesota, USA.
Gregg C FonarowAhmanson-UCLA Cardiomyopathy Center, University of California-Los Angeles, Los Angeles, California, USA.
Robert J MentzDivision of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Stephen J GreeneDivision of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA. Electronic address: stephen.greene@duke.edu.

Funding

Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
NHLBI NIH HHS T32 HL069749
6 · The paper itself

Abstract

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.

Indexed as

HospitalizationPatient ReadmissionSodium-Glucose Transporter 2 InhibitorsHeart FailureHumansHypoglycemic AgentsPatient-Centered CarePatient DischargePractice Guidelines as TopicRandomized Controlled Trials as TopicRiskSodium-Glucose Transporter 2Stroke VolumeVentricular Dysfunction, LeftHypoglycemic AgentsSLC5A2 protein, humanSodium-Glucose Transporter 2Sodium-Glucose Transporter 2 Inhibitorsguideline-directed medical therapyheart failurein-hospital prescribingmedical therapysodium-glucose cotransporter-2 inhibitors

Identifiers

PMID34763778
PMCPMC9766421

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.