Variation seen in rates of SGLT2i rx for heart failure, LVEF >40 percent

From 2021 to 2023, there was an increase in prescription rates of a sodium-glucose cotransporter-2 inhibitor (SGLT2i) for patients with heart failure and a left ventricular ejection fraction (LVEF) greater than 40 percent, according to a study published online Nov. 18 in JAMA Cardiology to coincide with the American Heart Association Scientific Sessions 2024, held from Nov. 16 to 18 in Chicago.

Mohammad Abdel Jawad, M.D., from the University of Missouri Kansas City Healthcare Institute for Innovations in Quality, and colleagues examined trends and hospital-level variation in SGLT2i adoption in a cohort study involving patients with LVEF >40 percent who were hospitalized for decompensated heart failure.

The researchers found that 13.9 percent of 158,849 eligible patients with heart failure and an LVEF >40 percent were prescribed an SGLT2i at hospital discharge. There was an increase in quarterly prescription rates from 4.2 percent in July to September 2021 to 23.5 percent in July to September 2023. Patients with heart failure with mildly reduced LVEF (41 to 49 percent) were more likely to have an SGLT2i prescription than those with preserved LVEF (≥50 percent; 18.5 versus 13.0 percent). There was high variance observed between hospitals in the rate of SGLT2i prescription after adjustment for patient characteristics (median odds ratio, 2.12). Among 518 hospitals with 10 or more eligible discharges, 2.1 and 44.8 percent discharged ≥50 percent and fewer than 10 percent of eligible patients with an SGLT2i prescription, respectively.

“This variation highlights the need to understand the strategies used by higher prescribing centers to increase SGLT2i adoption,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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