Sex Differences in SGLT2 Inhibitor Prescription Trends for Heart Failure with Reduced Ejection Fraction: A Population-Based Retrospective Cohort Study in Saskatchewan

Patients who have been prescribed SGLT2 inhibitors for heart failure have significantly better prognoses, having a lower risk of cardiovascular hospitalization and death. However, they are prescribed less often for female compared male heart failure patients. This researched aimed to evaluate local sex-differences in SGLT2 inhibitor prescription of hospitalized heart failure patients with low ejection fractions between 2022 and 2024 through chart review and subsequent data analysis with regression modelling. Analysis revealed that there were no significant sex-differences in SGLT2 inhibitor prescription, although its prescription did tend to increase each year in both groups. Additionally, while there were no significant sex-differences in any of the comorbidities, the interaction between diabetes and whether an SGLT2 inhibitor was prescribed is predictive of patient sex in regression modelling. Finally, there were significant sex-differences in the hemoglobin and eGFR laboratory analyses, with female patients having lower values compared to male patients. These results demonstrate the local implementation of guideline-directed medical therapy and how prescription has changed over the years.