Despite mounting evidence of benefit in acute heart failure (AHF), acute myocardial infarction (AMI), arrhythmias, and even intensive care settings, there remains a significant lack of clear guidance regarding the optimal timing for the initiation of sodium-glucose co-transporter 2 inhibitors (SGLT2i) [1]. Clinicians are left questioning whether these agents should be introduced within hours of admission, after clinical stabilization, or at the time of discharge. Similarly, ambiguity persists around which clinical and laboratory parameters—such as NT-proBNP, left ventricular ejection fraction (LVEF), or renal function—should guide their use.
