{"id":20441,"date":"2024-09-12T11:22:24","date_gmt":"2024-09-12T15:22:24","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=20441"},"modified":"2024-09-24T14:29:12","modified_gmt":"2024-09-24T18:29:12","slug":"timing-of-sodium-glucose-cotransporter-2-inhibitor-initiation-and-post-discharge-outcomes-in-acute-heart-failure-with-diabetes-a-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/timing-of-sodium-glucose-cotransporter-2-inhibitor-initiation-and-post-discharge-outcomes-in-acute-heart-failure-with-diabetes-a-population-based-cohort-study\/","title":{"rendered":"Timing of sodium\u2013glucose cotransporter 2 inhibitor initiation and post-discharge outcomes in acute heart failure with diabetes: a population-based cohort study"},"content":{"rendered":"<p><strong>Aims <\/strong>\u2014\u00a0Results from randomized trials suggest benefit of sodium\u2013glucose cotransporter 2 (SGLT2) inhibitor initiation in clinically stable acute heart failure. We aim to examine the real-world effectiveness of early versus delayed post-discharge SGLT2 inhibitor initiation in people with acute heart failure and type 2 diabetes.<\/p>\n<p><strong>Methods and results <\/strong>\u2014\u00a0Using linkable administrative databases in Ontario, Canada, individuals aged 66\u2009years or older with type 2 diabetes who were discharged to the community from acute care hospitals for heart failure between 1 July 2016 and 31 March 2020 were included in this retrospective, population-based cohort study. The primary outcome was hospitalization for heart failure (HHF) or cardiovascular mortality as a composite. Follow-up started from discharge for maximum 1 year. We compared outcomes between post-discharge SGLT2 inhibitor initiation within 3\u2009days, 4\u201390\u2009days, or 91\u2013180\u2009days, versus delayed initiation for at least 180\u2009days. The \u2018clone-censor-weight\u2019 approach with a target trial emulation framework was used to address time-related biases. There were 9641 eligible individuals. After cloning and artificial censoring, there were 38\u2009564 clones, 12\u2009439 person-years, and 7584 events. Compared to delayed initiation for at least 180\u2009days, initiation within 3\u2009days post-discharge was associated with a lower 1-year risk of HHF or cardiovascular mortality (risk ratio [RR] 0.65, 95% confidence interval [CI] 0.45\u20130.83), while initiation 4\u201390\u2009days (RR 0.83, 95% CI 0.72\u20130.93) or 91\u2013180\u2009days (RR 0.89, 95% CI 0.79\u20130.97) showed smaller risk reduction.<\/p>\n<p><strong>Conclusion<\/strong> \u2014\u00a0Real-world evidence supports early SGLT2 inhibitor initiation to reduce HHF or cardiovascular mortality in acute heart failure and type 2 diabetes.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Aims \u2014\u00a0Results from randomized trials suggest benefit of sodium\u2013glucose cotransporter 2 (SGLT2) inhibitor initiation in clinically stable acute heart failure. We aim to examine the real-world effectiveness of early versus delayed post-discharge SGLT2 inhibitor initiation in people with acute heart failure and type 2 diabetes. Methods and results \u2014\u00a0Using linkable administrative databases in Ontario, Canada, [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[42,50,56],"migration-helper-qa-sample-set":[],"class_list":["post-20441","journal_article","type-journal_article","status-publish","hentry","topic-chronic-diseases-and-multimorbidity","topic-endocrinology","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Wu CY, Shah BR, Sharma A, Sheng Y, Liu PP, Kopp A, Saskin R, Edwards JD, Swardfager W. <em>Eur J Heart Fail<\/em>. 2024; Sep 12 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1002\/ejhf.3464","ices_scientist":[1361,1360,1224],"site":[6733],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- 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