SGLT2 Inhibitors in Heart Failure: A Real-World Analysis of Eligibility and Prescribing Barriers in Internal Medicine

Abstract

Background and Aims: SGLT2 inhibitors have demonstrated significant cardiovascular benefits in patients with heart failure, regardless of diabetic status. Despite guideline recommendations, their uptake in Internal Medicine settings remains suboptimal. This study aimed to assess the proportion of eligible patients and explore clinicians’ concerns limiting prescription.

Materials/Patients and Methods: We retrospectively reviewed all admissions for acute heart failure in in our Internal Medicine Unit from December 2024 to May 2025. Eligibility for SGLT2 inhibitors was assessed based on ESC 2023 guidelines and drug labeling. An anonymous questionnaire was distributed to physicians at some Internal Medicine Units in Campania to identify perceived obstacles and risks.