ArticleBMJ (Clinical research ed.)2024
SGLT-2 inhibitors and mortality among patients with heart failure with reduced ejection fraction: linked database study.
Article in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Survival benefit of guideline-directed medical therapy in older patients with heart failure: a systematic review and meta-analysis.Heart (British Cardiac Society) · 2026Pooled it
- SGLT2 inhibitor prescription at discharge in very old adults with heart failure irrespective of diabetes status.International journal of cardiology. Heart & vasculature · 2026Article
- Heart-liver co-management in MASLD: expert perspectives and recommendations from a multidisciplinary cardiometabolic framework.Nature reviews. Gastroenterology & hepatology · 2026Review
- Effectiveness and safety of sodium-glucose cotransporter-2 inhibitor initiation in sacubitril-valsartan users with heart failure: a population-based cohort study.European heart journal. Cardiovascular pharmacotherapy · 2026Observational
- Impact of herpes zoster and post-zoster SGLT2 inhibitors initiation on cardiorenal outcomes in type 2 diabetes mellitus.BMC endocrine disorders · 2026Article
- Neural Upregulation of SGLT2-MAP17-PDZK1 Complex in Kidneys of Rats With Heart Failure.Hypertension (Dallas, Tex. : 1979) · 2026Article
- Initiation of SGLT2 inhibitors versus mineralocorticoid receptor antagonists as third-line therapy in heart failure with reduced ejection fraction: a nationwide cohort study.The Lancet regional health. Europe · 2026Article
- Next-Generation SGLT2 Inhibitors: Innovations and Clinical Perspectives.Biomedicines · 2025Review
- Review
- TyG-BMI index as a valuable risk of acute kidney injury in patients with heart failure: Insights from the MIMIC-IV and eICU cohorts.Journal of diabetes investigation · 2025Article
- SGLT2 Inhibitors: Multifaceted Therapeutic Agents in Cardiometabolic and Renal Diseases.Metabolites · 2025Review
- Review
- Testosterone-induced erythrocytosis: addressing the challenge of metabolic syndrome and widely prescribed SGLT2-inhibitor drugs.Endocrine connections · 2025Review
- SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical Considerations.Medicina (Kaunas, Lithuania) · 2025Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the association between sodium-glucose cotransporter-2 (SGLT-2) inhibitor use and risk of all cause mortality among patients with heart failure with reduced ejection fraction.
designLinked database study.
settingNational registers in Denmark, July 2020 to June 2023.
participantsPatients with heart failure, aged ≥45 years, with left ventricular ejection fraction ≤40%.
main outcome measuresThe primary outcome was all cause mortality comparing initiation and continued treatment with SGLT-2 inhibitors versus continued treatment with other standard-of-care heart failure drugs and non-use of SGLT-2 inhibitors; secondary outcomes were the composite of cardiovascular mortality or admission to hospital with heart failure and its individual components. Hazard ratios were estimated using Cox regression adjusted using inverse probability of treatment weighting based on propensity scores.
resultsThe study included 6776 patients who started SGLT-2 inhibitors (79% dapagliflozin; 21% empagliflozin) and 14 686 patients who remained on other standard-of-care heart failure drugs and did not use SGLT-2 inhibitors. Most SGLT-2 inhibitor users were male (70%), the mean age was 71.2 (standard deviation 10.6) years, and 20% had type 2 diabetes. During follow-up, 374 deaths occurred among SGLT-2 inhibitor users (incidence rate 5.8 per 100 person years) and 1602 among non-users (8.5 per 100 person years). The weighted hazard ratio for all cause mortality was 0.75 (95% confidence interval 0.66 to 0.85); the weighted incidence rate difference was -1.6 (95% confidence interval -2.5 to -0.8) per 100 person years. Secondary outcomes showed a weighted hazard ratio of 0.94 (0.85 to 1.04) for cardiovascular mortality or hospital admission with heart failure, 0.77 (0.64 to 0.92) for cardiovascular mortality, and 1.03 (0.92 to 1.15) for hospital admission with heart failure. The weighted hazard ratios for all cause mortality were consistent in patients with and without diabetes (0.73 (0.58 to 0.91) and 0.73 (0.63 to 0.85); P=0.99).
conclusionsIn this large database study among patients with heart failure with reduced ejection fraction, SGLT-2 inhibitor use was associated with a 25% lower risk of all cause mortality, supporting their effectiveness in routine clinical practice.
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