The information about the activity and initiation of sodium-glucose cotransporter2 (SGLT2) inhibitor is limited. Also, the said data is incomplete and uncertain in cases of patients hospitalized with acute heart failure with or without the pre-existing condition of diabetes type 2.

A study aimed at reviewing systemic information and meta-analysis of the collected data was conducted to determine the safety and efficacy of SGLT2 inhibitors in patients hospitalized for AHF. Several sites such as PubMed/Medline, Embase, and Cochrane library were searched using the keywords such as ‘SGLT2 and acute heart failure, ‘SGLT2 and worsening heart failure. The data was also collected from the presentation of major cardiovascular and diabetic scientific meets and events. All the cases recorded till 15th November 2021 in a randomized controlled trial format were included in the analysis. The efficacy outcomes were set as mortality, rehospitalization for heart failure, and improvement in KCCQ scale scores while the safety outcomes were pre-set at acute kidney injury, hypotension, and hypoglycemia. 

In the study, three trials were included accounting for 1831 patient information and profile for analysis. Based on the analysis, it was concluded that SGLT2 inhibitors in AHF patients reduced the risk of rehospitalization risk by an odds ratio of 0.52. The KCCQ scale score was recorded in terms of mean difference at 4.12, thus showing an improvement in the situation. However, no significant effect of initiation of SGLT2 inhibitors on all-cause mortality was recorded. Initiation of SGLT2 inhibitors in subjects did not increase the risk of acute kidney injury, hypotension, or hypoglycemia by the odd ratio of 0.76, 1.17, and 1.51 respectively. From the result, it was concluded that the initiation of an SGLT2 inhibitor in patients hospitalized for acute heart failure reduces the risk of rehospitalization. It showed a similar effect for cases in early post-discharge periods. Also, improvement in condition was reported with no significant adverse effect in the subjects.

Salah H. M et al., Cardiovascular diabetology, 21(1), 20. https://doi.org/10.1186/s12933-022-01455-2