{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:02:07Z","timestamp":1791892927232,"version":"4.3.4"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["202111FBD-47623-75801"],"award-info":[{"award-number":["202111FBD-47623-75801"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs Program","doi-asserted-by":"crossref","award":["CRC-2024-00213"],"award-info":[{"award-number":["CRC-2024-00213"]}],"id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ontario Ministry of Colleges and Universities","award":["ER21-16-146"],"award-info":[{"award-number":["ER21-16-146"]}]},{"name":"Dr. Sandra Black Centre for Brain Resilience and Recovery"},{"name":"Heart-Brain Connection BHRIITE"},{"DOI":"10.13039\/501100024951","name":"IMPACT","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024951","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004411","name":"Heart & Stroke Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Brain-Heart Interconnectome CFREF"},{"name":"Canadian federal government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Large-scale real-world evidence regarding outcomes of sodium-glucose cotransporter-2 inhibitors (SGLT2i) initiation added to sacubitril-valsartan is currently limited. We aim to investigate effectiveness and safety of SGLT2i initiation among older sacubitril-valsartan users with heart failure in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This prevalent new-user cohort study used linkable administrative data in Ontario, Canada, to emulate a target trial. In sacubitril-valsartan users with heart failure aged \u226566 years, SGLT2i initiators were matched on time-conditional propensity scores to non-initiators (October 2019 to June 2024). The primary effectiveness outcome was a composite of hospitalization for heart failure (HHF) or all-cause mortality. We also studied safety outcomes, including acute kidney injury (AKI), genital infection, urinary tract infection (UTI), falls, hospitalization for hypotension, diabetic ketoacidosis, and hypoglycaemia. Among 5000 matched pairs, SGLT2i initiation was associated with lower HHF or all-cause mortality [hazard ratio (HR) 0.71, 95% confidence interval 0.64\u20130.78; 1-year absolute risk: 13.9% vs. 19.2%]. Sodium-glucose cotransporter-2 inhibitor initiation was associated with a higher genital infection risk (2.36, 1.58\u20133.51; 1.8% vs. 0.7%) but not with higher rates of falls, hospitalization for hypotension, or UTI. Diabetic ketoacidosis was uncommon among SGLT2i users with diabetes as were hypoglycaemic events among SGLT2i users without diabetes. Sodium-glucose cotransporter-2 inhibitor initiation showed lower AKI among those with diabetes (0.78, 0.66\u20130.94) but not among those without diabetes (1.01, 0.66\u20130.94; HR homogeneity: P = 0.035).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This observational real-world evidence study supports effectiveness of SGLT2i among older sacubitril-valsartan users with heart failure, and suggests no increase in the safety outcomes studied, except genital infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvag031","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:44:29Z","timestamp":1778067869000},"page":"269-281","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness and safety of sodium-glucose cotransporter-2 inhibitor initiation in sacubitril-valsartan users with heart failure: a population-based cohort study"],"prefix":"10.1093","volume":"12","author":[{"given":"Che-Yuan","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Toxicology, University of Toronto , 777 Bay Street, Toronto, Ontario M5G 2R3 ,","place":["Canada"]},{"name":"Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute , 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3598-3628","authenticated-orcid":false,"given":"Baiju R","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Sunnybrook Health Sciences Centre , 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 ,","place":["Canada"]},{"name":"Department of Medicine, Temerty Faculty of Medicine, University of Toronto , 6 Queen\u2032s Park Crescent West, Toronto, Ontario M5S 3H2 ,","place":["Canada"]},{"name":"ICES , 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2724-4086","authenticated-orcid":false,"given":"Justin A","family":"Ezekowitz","sequence":"additional","affiliation":[{"name":"Mazankowski Alberta Heart Institute, University of Alberta , 11220 83 Avenue, Edmonton, Alberta T6G 2B7 ,","place":["Canada"]},{"name":"Canadian VIGOUR Centre, University of Alberta , 4-120 Katz Group Centre for Pharmacy and Health Research, Edmonton, Alberta T6G 2E1 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2346-8330","authenticated-orcid":false,"given":"Abhinav","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Cardiology, McGill University Health Centre, McGill University , 1001 Boulevard D\u00e9carie, Montreal, Quebec H4A 3J1 ,","place":["Canada"]},{"name":"DREAM-CV Lab, McGill University Health Centre, McGill University , 1001 Boulevard D\u00e9carie, Montreal, Quebec H4A 3J1 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianru","family":"Wang","sequence":"additional","affiliation":[{"name":"ICES , 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Fangyun","family":"Wu","sequence":"additional","affiliation":[{"name":"ICES , 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter P","family":"Liu","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, University of Ottawa , 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi D","family":"Edwards","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, University of Ottawa , 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 ,","place":["Canada"]},{"name":"School of Epidemiology and Public Health, University of Ottawa , 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3 ,","place":["Canada"]},{"name":"ICES uOttawa , 1053 Carlind Avenue, Ottawa, Ontario K1Y 4E9 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0030-8908","authenticated-orcid":false,"given":"Walter","family":"Swardfager","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, University of Toronto , 777 Bay Street, Toronto, Ontario M5G 2R3 ,","place":["Canada"]},{"name":"Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute , 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 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