{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:41:15Z","timestamp":1791600075583,"version":"4.3.4"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T00:00:00Z","timestamp":1642377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Sodium\u2013glucose co\u2010transporter 2 (SGLT2) inhibitors have recently been recommended as a foundational therapy for patients with heart failure (HF) and reduced ejection fraction (HFrEF) because of their favourable effects on mortality, clinical events and quality of life. While clinical practice guidelines have recommended dapagliflozin or empagliflozin in all patients with HFrEF, or sotagliflozin in those with HFrEF and concomitant diabetes, the timing and practical integration of these drugs in clinical practice is less well defined. We propose that these drugs are candidates for early, upfront administration to patients with newly diagnosed HFrEF and for patients hospitalized with HF. Growing evidence has established early benefits, with clinically meaningful reductions in clinical events that reach statistical significance within days to weeks, following dapagliflozin, empagliflozin or, in diabetic patients, sotagliflozin initiation. Secondly, although major clinical trials have tested these drugs in patients already receiving background HF therapy, secondary analyses showed that their efficacy is independent of that. Third, SGLT2 inhibitors are generally safe and well tolerated, with clinical trial data reporting minimal effects on blood pressure, glycaemia\u2010related adverse events, and no excess in acute kidney injury. Rather, they exert renal protective effects and reduce risk of hyperkalaemia, properties that favour initiation, tolerance and persistence of renin\u2013angiotensin system inhibitors and mineralocorticoid receptor antagonists. This review supports the early initiation of dapagliflozin and empagliflozin (or sotagliflozin limited to patients with diabetes) to rapidly improve clinical outcome and quality of life of HFrEF patients.<\/jats:p>","DOI":"10.1002\/ejhf.2397","type":"journal-article","created":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T01:39:25Z","timestamp":1639186765000},"page":"431-441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":111,"title":["Sodium\u2013glucose co\u2010transporter 2 inhibitors as an early, first\u2010line therapy in patients with heart failure and reduced ejection fraction"],"prefix":"10.1093","volume":"24","author":[{"given":"Daniela","family":"Tomasoni","sequence":"first","affiliation":[{"name":"Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson\u2010UCLA Cardiomyopathy Center Ronald Reagan\u2010UCLA Medical Center  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Adamo","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Mississippi School of Medicine  Jackson MS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"Department of Cardiology IRCCS San Raffaele Pisana  Rome Italy"},{"name":"Faculty of Medicine University of Warwick  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens School of Medicine Athens University Hospital Attikon  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham NC USA"},{"name":"Division of Cardiology Duke University School of Medicine  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa A.","family":"McDonagh","sequence":"additional","affiliation":[{"name":"School of Cardiovascular Medicine and Sciences King's College London British Heart Foundation Centre of Excellence, James Black Centre  London UK"},{"name":"Department of Cardiology King's College Hospital London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Department of Heart Diseases Wroclaw Medical University &amp; Centre for Heart Diseases, University Hospital  Wroclaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rosano","sequence":"additional","affiliation":[{"name":"Department of Cardiology IRCCS San Raffaele Pisana  Rome Italy"},{"name":"Cardiovascular Clinical Academic Group St George's Hospitals NHS Trust University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Seferovic","sequence":"additional","affiliation":[{"name":"Department Faculty of Medicine University of Belgrade, Belgrade &amp; Serbian Academy of Sciences and Arts  Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Heart &amp; Vascular Center and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriaan A.","family":"Voors","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Centre Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,17]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2333"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1459"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13223"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2271"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.070"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft134"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1182"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1793"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvab033"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1673"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1954"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2026"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13124"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911303"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2022190"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2030183"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.0898"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2286"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz486"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611925"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812389"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504720"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1536"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1906"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.051824"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2018.09.019"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.054442"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2137"},{"key":"e_1_2_5_30_1","article-title":"The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure","author":"Voors AA","year":"2021","journal-title":"Nat Med"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107038"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1596"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.056824"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.7585"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.051783"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa1007"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044138"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2015.14"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2020.04.007"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2075"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa183"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00292-8"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1713"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-020-01790-y"},{"key":"e_1_2_5_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa496"},{"key":"e_1_2_5_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.07.049"},{"key":"e_1_2_5_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.05.002"},{"key":"e_1_2_5_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1697"},{"key":"e_1_2_5_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2066"},{"key":"e_1_2_5_50_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2020.602251"},{"key":"e_1_2_5_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30256-6"},{"key":"e_1_2_5_52_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2024816"},{"key":"e_1_2_5_53_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.050391"},{"key":"e_1_2_5_54_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.051685"},{"key":"e_1_2_5_55_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2030186"},{"key":"e_1_2_5_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.11.009"},{"key":"e_1_2_5_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.01.044"},{"key":"e_1_2_5_58_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab497"},{"key":"e_1_2_5_59_1","doi-asserted-by":"publisher","DOI":"10.2337\/db15-1356"},{"key":"e_1_2_5_60_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1503102"},{"key":"e_1_2_5_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00180-7"},{"key":"e_1_2_5_62_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa968"},{"key":"e_1_2_5_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2220"},{"key":"e_1_2_5_64_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.037778"},{"key":"e_1_2_5_65_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2021.1437"},{"key":"e_1_2_5_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1978"},{"key":"e_1_2_5_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.022"},{"key":"e_1_2_5_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2021.01.017"},{"key":"e_1_2_5_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2311"},{"key":"e_1_2_5_70_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2021.0496"},{"key":"e_1_2_5_71_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2206"},{"key":"e_1_2_5_72_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.120.008030"}],"updated-by":[{"DOI":"10.1002\/ejhf.2789","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000}}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.2397","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejhf.2397","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.2397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:16:17Z","timestamp":1767701777000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejhf.2397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,17]]},"references-count":71,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1002\/ejhf.2397"],"URL":"https:\/\/doi.org\/10.1002\/ejhf.2397","archive":["Portico"],"relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,17]]},"assertion":[{"value":"2021-11-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}