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The Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Reducing Repeated Heart Failure Rehospitalizations Among

Michitaka Amioka1, Hiroki Kinoshita2, Yuto Fuji3

  • 1Deparment of Cardiovascular Medicine, Shininokuchi Medical Clinic, Hiroshima, Japan; Deparment of Cardiovascular Medicine, Hiroshima General Hospital, Hiroshima, Japan.

The American Journal of Cardiology
|July 14, 2025
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) significantly reduce recurrent heart failure hospitalizations in elderly patients after acute decompensated heart failure. This therapy offers valuable long-term benefits for older adults with heart failure.

Area of Science:

  • Cardiology
  • Pharmacology
  • Geriatrics

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2i) demonstrate cardiovascular benefits in chronic heart failure.
  • Limited data exist on the long-term efficacy of SGLT2i in preventing recurrent hospitalizations post-acute decompensated heart failure (ADHF) in elderly individuals.

Purpose of the Study:

  • To evaluate the long-term impact of SGLT2i on recurrent heart failure (HF) hospitalizations in patients aged 75 years and older following an initial ADHF admission.

Main Methods:

  • The ROSES-HF study was a multicenter, prospective observational cohort study.
  • 415 patients aged ≥75 years hospitalized with ADHF were divided into conventional therapy (n=206) and SGLT2i therapy (n=209) groups.
  • Recurrent HF hospitalization and a composite endpoint of HF hospitalization or cardiovascular death were compared over a mean follow-up of 22.4 months.

Main Results:

  • SGLT2i initiation was associated with a significant reduction in recurrent HF hospitalizations (20.6% vs. 31.6%, p=0.028).
  • Annualized HF rehospitalization rates were lower in the SGLT2i group (15.7 vs. 24.1 per 100 person-years, p=0.007).
  • The composite endpoint of HF hospitalization or cardiovascular death was significantly reduced in the SGLT2i group (23.4% vs. 37.4%, p=0.017).

Conclusions:

  • Initiating SGLT2i in elderly patients following ADHF admission effectively reduces recurrent HF hospitalizations.
  • SGLT2i therapy demonstrates significant therapeutic value in older adults with heart failure, improving long-term outcomes.

Keywords:
cardiovascular deathejection fractionheart failurerepeated rehospitalizationsodium-glucose cotransporter 2 inhibitors

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