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Sodium-glucose cotransporter 2 inhibitors reduce cardiovascular events in acute heart failure. A real-world analysis

      Since the recent past, sodium-glucose cotransporter type 2 inhibitors (SGLT2i) have been recommended as mainstay therapy for patients with chronic heart failure (HF) and reduced ejection fraction (HFrEF) due to their positive effects on mortality, clinical events, and quality of life. (
      • Brown E
      • Heerspink HJL
      • Cuthbertson DJ
      • Wilding JPH.
      SGLT2 inhibitors and GLP-1 receptor agonists: established and emerging indications.
      ) Thus, clinical practice guidelines have recommended its use regardless of a history of diabetes. (
      • Mcdonagh TA
      • Metra M
      • Adamo M
      • Gardner RS
      • Baumbach A
      • Böhm M
      • et al.
      2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.
      ) On the other hand, the appropriateness of its introduction during the acute phase of HF is less well defined. There seems to be increasing evidence from clinical trial sub-analyses that these drugs can produce early benefits, with clinically significant reductions in clinical events within days or weeks after hospital discharge. (
      • Damman K
      • Beusekamp JC
      • Boorsma EM
      • Swart HP
      • Smilde TDJ
      • Elvan A
      • et al.
      Randomized, double-blind, placebo-controlled, multicentre pilot study on the effects of empagliflozin on clinical outcomes in patients with acute decompensated heart failure (EMPA-RESPONSE-AHF).
      ) However, these data have not been verified in real life as the use of these drugs has not been fully implemented in the cardiac decompensation phase. This study aimed to compare in a real-world setting whether, in patients hospitalized for decompensated HF, the prescription of an SGLT2i versus no prescription during admission results in lower short-term morbidity and mortality.
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