{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:27:41Z","timestamp":1793039261241,"version":"4.5.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,4,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Observational studies and small randomized controlled trials have suggested the benefits of early introduction of sodium\u2013glucose cotransporter 2 inhibitors (SGLT2is) in acute heart failure (AHF). However, current evidence on their efficacy and safety in this clinical setting remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We performed a systematic review and meta\u2010analysis to assess efficacy\/safety of early use of SGLT2is in AHF. PUBMED\/EMBASE\/Cochrane were searched from inception to May 31, 2024, for randomized controlled trials evaluating outcomes of SGLT2i early initiation in patients with AHF. Efficacy outcomes were all\u2010cause death and heart failure rehospitalizations. Safety outcomes included acute kidney injury, ketoacidosis, urinary tract infections, hypotension, and hypoglycemia. Early initiation was defined as performed before or shortly after discharge (within 3\u2009days). A sensitivity analysis was conducted, including only patients with initiation before discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Seven randomized controlled trials that enrolled 2320 patients were included. Early use of SGLT2is was associated with a significant reduction in all\u2010cause death (odds ratio, 0.71 [95% CI, 0.55\u20130.92; 95% PI, 0.55\u20130.98]) and HF rehospitalizations (odds ratio, 0.73 [95% CI, 0.57\u20130.94; 95% PI, 0.58\u20130.93]), even after adjusting for follow\u2010up duration. SGLT2i initiation before discharge yielded consistent results for efficacy outcomes. Safety outcomes could not be usefully determined because of a low events rate resulting in wide CIs. The impact of diabetic status remains basically unknown due to the small number of available randomized controlled trials investigating this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Early introduction of SGLT2is in AHF improves all\u2010cause death and rehospitalization rates, can be performed before discharge, and should be offered to most patients with AHF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.039105","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T23:13:33Z","timestamp":1744067613000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Early Initiation of Sodium\u2013Glucose Cotransporter 2 Inhibitors in Acute Heart Failure: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8952-6283","authenticated-orcid":false,"given":"Miloud","family":"Cherbi","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paul Sabatier \u2010 Toulouse III","place":["Toulouse, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8141-6582","authenticated-orcid":false,"given":"Olivier","family":"Lairez","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paul Sabatier \u2010 Toulouse III","place":["Toulouse, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9200-2729","authenticated-orcid":false,"given":"Guillaume","family":"Baudry","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d\u2019Investigations Cliniques Plurith\u00e9matique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et des Vaisseaux","place":["Nancy, France"]},{"name":"INI\u2010CRCT (Cardiovascular and Renal Clinical Trialists), F\u2010CRIN Network","place":["Nancy, France"]},{"name":"CHU de Toulouse","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9934-8432","authenticated-orcid":false,"given":"Paul","family":"Gautier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paul Sabatier \u2010 Toulouse III","place":["Toulouse, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5288-9687","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Roubille","sequence":"additional","affiliation":[{"name":"Arnaud\u2010De\u2010Villeneuve Hospital","place":["Montpellier, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9180-9128","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Delmas","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paul Sabatier \u2010 Toulouse III","place":["Toulouse, France"]},{"name":"CHU de 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