Uniform efficacy of SGLT2 inhibitors across the ejection fraction spectrum and in high-risk patients with HFpEF: a prespecified pooled analysis

Background Heart failure with preserved ejection fraction (HFpEF) accounts for over half of all heart failure cases and imposes a high symptom burden. Although SGLT2 inhibitors are guideline-recommended, it remains uncertain whether their efficacy is uniform across the entire LVEF spectrum and in high-risk populations like recently hospitalized patients. Objective To definitively assess the consistency of SGLT2 inhibitor efficacy and safety across LVEF subgroups and in extended, high-risk HFpEF populations through a prespecified pooled analysis. Methods This trial-level pooled analysis included 12,251 HFpEF patients (LVEF >40%) from the EMPEROR-Preserved and DELIVER trials. Prespecified subgroups were defined by baseline LVEF (