In patients hospitalized for acute heart failure (AHF), sodium-glucose cotransporter 2 (SGLT2) inhibitors initiation during hospitalization or early post-discharge (within 3 days) was found to be associated with decreased risk of rehospitalization for heart failure and improved patient-reported outcomes with no excess risk of adverse impacts.

• In this systematic review and meta-analysis of three randomized controlled trials with a total of 1,831 patients, the efficacy as well as safety of SGLT2 inhibitors initiated in patients hospitalized for AHF was assessed.

• In AHF cases, SGLT2 inhibitors initiation led to decreased risk of rehospitalization for heart failure (odds ratio,OR: 0.52) and improved Kansas City Cardiomyopathy Questionnaire scores (mean difference 4.12).

• Initiation of SGLT2 inhibitors did not statistically significantly impact all-cause mortality (OR 0.70).

• Initiation of SGLT2 inhibitors did not increase the acute kidney injury (OR 0.76), hypotension (OR 1.17), or hypoglycemia (OR 1.51).