Reporter brief

In a US cohort of 99,738 patients hospitalized for heart failure (mean age 78 years), early empagliflozin initiation (during hospitalization or within 7 days post-discharge) was associated with lower 1-year all-cause mortality (RR 0.73) compared to delayed or no initiation, with absolute 1-year mortality of 24.7% versus 33.6%. Early initiation was also associated with reduced worsening HF events (RR 0.89), HF rehospitalizations (RR 0.86), ED visits (RR 0.87), and all-cause hospitalizations (RR 0.91).

Assessment pending; this report does not establish a change in evidence.

• —Limitations have not been recorded; consult the primary source.

Cohort; Human.

Adults hospitalised for heart failure between September 2021 and December 2023 from the Optum de-identified Clinformatics Data Mart (mean age 78.0 years; 54.2% female)

Design

Cohort

Sample

99,738

Journal

ESC Heart Failure

Published

Sep 22, 2026

Early vs delayed/no initiation for all-cause mortality: RR 0.73 (95% CI: 0.69-0.78); Intermediate vs delayed/no initiation for all-cause mortality: RR 0.93 (95% CI: 0.89-0.97); Early vs delayed/no for worsening HF events: RR 0.89 (95% CI: 0.84-0.94); Early vs delayed/no for HF rehospitalisations: RR 0.86 (95% CI: 0.81-0.92); Early vs delayed/no for ED visits: RR 0.87 (95% CI: 0.82-0.93); Early vs delayed/no for all-cause hospitalisations: RR 0.91 (95% CI: 0.88-0.94)

• —Assessment: Superseded.
• —Only the source material recorded on this evidence page was assessed.

Not recorded.

See the SGLT2 inhibitors timeline and recorded assessment for prior evidence.