Early administration of SGLT2 inhibitors in hospitalized patients: A practical guidance from the current evidence

Area of Science:

• Cardiology
• Pharmacology
• Internal Medicine

Background:

• Sodium-glucose cotransporter-2 (SGLT2) inhibitors are crucial for heart failure management.
• Clinical trials confirm cardiovascular benefits, yet timing of initiation in practice remains a challenge.
• Concerns about side effects and drug interactions can delay SGLT2 inhibitor use in acute settings.

Purpose of the Study:

• To review evidence supporting early administration of SGLT2 inhibitors in acute heart failure.
• To discuss the safety and prognostic impact of SGLT2 inhibitors in hospitalized patients.
• To propose a practical flowchart for early SGLT2 inhibitor use in acute settings.

Main Methods:

• Review of key clinical trials on early SGLT2 inhibitor administration in acute heart failure.
• Analysis of safety and efficacy data in acute myocardial infarction patients.
• Synthesis of evidence to develop a clinical decision-making flowchart.

Main Results:

• Studies demonstrate the safety and prognostic benefits of SGLT2 inhibitors in hospitalized heart failure patients.
• Early initiation during hospitalization or post-discharge is identified as an optimal therapeutic strategy.
• Evidence supports the use of SGLT2 inhibitors in acute myocardial infarction.

Conclusions:

• Early introduction of SGLT2 inhibitors optimizes heart failure treatment.
• Hospitalization or early post-discharge is a suitable period for initiating SGLT2 inhibitors.
• A proposed flowchart aids clinicians in the timely prescription of SGLT2 inhibitors.