ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Socioeconomic factors and SGLT2 inhibitor initiation in patients with heart failure-a claims data analysis.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study was aimed at analysing the association between socioeconomic factors and SGLT2 inhibitor (SGLT2i) initiation in patients with heart failure.
methodsIn this retrospective analysis, German health insurance claims data from 2022 to 2023 were used, covering more than 2.8 million individuals. Heart failure was defined using ICD-10-GM codes. Area-based socioeconomic data were obtained from the INKAR database. Associations were assessed using a multilevel logistic regression analysis.
resultsIn 2023, 90,841 individuals were diagnosed with heart failure. After excluding patients with prior SGLT2i use in 2022 and those with missing data, 68,426 SGLT2i-naive individuals were included in the analysis. A higher likelihood of SGLT2i initiation was associated with newly coded heart failure (adjusted odds ratio (aOR): 2.42, 95% CI 2.29-2.56) and new enrolment in a disease management program for coronary artery disease (aOR: 1.89, 95% CI 1.68-2.12). Being a pensioner (aOR: 0.86, 95% CI 0.78-0.93), having family insurance (aOR: 0.79, 95% CI 0.66-0.95), moving (aOR: 0.80, 95% CI 0.67-0.95), being female (aOR: 0.83, 95% CI 0.78-0.87), and older age (aOR: 0.37, 95% CI 0.18-0.76) were negatively associated. At the municipal level, residing in a higher-income tax municipality (aOR: 1.70, 95% CI 1.37-2.09) was positively related to SGLT2i initiation. These associations were adjusted for other socioeconomic factors, comorbidities, and heart failure medications.
conclusionsWomen and individuals living in socioeconomically disadvantaged municipalities were less likely to receive SGLT2i initiation for heart failure.
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