BACKGROUND:Transcatheter aortic valve implantation (TAVI) is a viable alternative therapeutic approach for patients with severe aortic stenosis (AS), following technological innovations in transcatheter aortic valve systems and advances in clinical expertise, which aim to optimize valve hemodynamics. In this study, we aimed to compare early hemodynamic changes in different types of TAVI valves via two-dimensional echocardiography. METHODS:This retrospective observational study examined patients with severe AS who underwent transfemoral TAVI. Patients were classified according to expansion mechanism (self-expanding valves (SEVs) or balloon-expandable valves (BEVs)) and leaflet position relative to the annulus (supra-annular valves (SAVs) or intra-annular valves (IAVs)). The implanted prostheses were Edwards SAPIEN XT valves (ESV, Edwards Lifesciences, Irvine, CA, USA), Medtronic valves (Core Valve-MCV and Evolut R, Medtronic, Minneapolis, MN, USA), Portico valves (St. Jude Medical, Saint Paul, MN, USA), and Myval valves (Meril Life Sciences, Vapi, India). Baseline two-dimensional transthoracic echocardiography (TTE) datasets were compared with post-TAVI measures obtained before discharge. RESULTS:In total (n = 332), 275 (82.8%) patients were treated with SEVs, and 57 (17.2%) were treated with BEVs. In terms of leaflet position, 249 (75%) patients were treated with SAVs, and the remaining 83 (25%) patients were treated with IAVs. Transaortic gradients were comparable between patients treated with SEVs and BEVs. However, patients treated with IAVs exhibited significantly higher aortic maximum gradients (16 [13-21] mmHg vs. 14 [10-20] mmHg, p = 0.019) and mean gradients (9 [7-11] mmHg vs. 8 [5-10] mmHg, p = 0.014) compared to those receiving SAVs. Post-TAVI gradients were also compared based on each TAVI device. Although post-TAVI aortic maximum gradient was comparable among TAVI devices (p = 0.080), aortic mean gradient was significantly different among the valves (p = 0.006). Post hoc analyses demonstrated that the post-TAVI mean gradient was significantly lower in Medtronic CoreValve compared to the Myval (p = 0.013) and Portico (p = 0.030). No significant differences were observed in the frequency of perivalvular leak between the valve groups. CONCLUSIONS:We found that post-TAVI transaortic gradients of SEVs and BEVs were comparable; however, SAVs were associated with lower transaortic gradients than those of the IAVs. In addition, the frequency of ≥moderate PVL was comparable between the valve groups.

The relationship between the combination of bleomycin-etoposide-cisplatin, a chemotherapeutic treatment option used in testicular carcinomas, and acute thrombotic events has been previously described. Acute coronary syndromes associated with this treatment have been frequently reported. The differences in the underlying mechanisms that lead to coronary events suggest that the treatment options may vary in these situations. The decision regarding the right treatment option for the patient sometimes emerges after a relatively long process that requires patience. In this event, which occurs without atherosclerosis and involves vasospasm and thrombus formation, a conservative approach may be beneficial. A 42-year-old individual diagnosed with testicular cancer who did not have any cardiac risk factors was diagnosed with acute coronary syndrome. Since no atherosclerotic background is observed on coronary angiography, coronary intervention is postponed. In this case, the management of the patient will be discussed with a focus on medical treatment without any coronary intervention.

Background: Immunopathological dysregulation has been implicated as a unifying substrate for both atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), 2 conditions that cluster with disproportionate frequency in clinical cardiology practice. Systemic immune-inflammation index (SII)—a hematological index derived from the ratio of platelet–neutrophil product to lymphocyte count—has garnered increasing attention as a low-burden inflammatory surrogate. The capacity to discriminate AF from sinus rhythm was investigated in an outpatient cohort with HFpEF. Methods: A retrospective analysis was conducted on 207 HFpEF outpatients (January 2024-January 2025) stratified by resting electrocardiogram rhythm: sinus rhythm (group 1, n = 105) vs. AF (group 2, n = 102). Independent AF predictors were identified through multivariate binary logistic regression. Results: Four variables independently predicted AF on multivariate analysis: SII (P = .04), age (P = .010), left atrial diameter (P < .001), and systolic pulmonary artery pressure (P < .001). At an optimal SII threshold of 584.64, sensitivity reached 79.4% and specificity 59% for AF prediction (AUC = 0.727, 95% CI = 0.658-0.796, P < .001). Conclusion: Systemic immune-inflammation index constitutes a cost-neutral, universally derivable hematological parameter with meaningful clinical utility for AF risk stratification within the HFpEF phenotype. Patients harboring pronounced SII elevation warrant heightened arrhythmia vigilance through serial 12-lead recordings and extended ambulatory electrocardiographic monitoring—should be considered in HFpEF patients with markedly elevated SII to facilitate timely AF detection. Cite this article as: Şentürk B, Kış M, Çöllüoğlu T, et al. The relationship between the systemic immune inflammatory index and atrial fibrillation in heart failure with preserved ejection fraction. Eurasian J Med. 2026, 58(4), 1589, doi: 10.5152/ eurasianjmed.2026.261589.

Background and Objectives: Recurrent myocarditis confers a significant prognostic burden yet lacks validated predictive markers to guide risk stratification. This study aimed to identify independent clinical, electrocardiographic, and cardiac magnetic resonance (CMR) determinants of recurrence at a median of 7 days (IQR: 3–14) after the index event in young adults with acute myocarditis and to evaluate the role of colchicine therapy duration in modulating recurrence risk. Materials and Methods: This retrospective observational cohort study enrolled 162 patients admitted with a diagnosis of acute myocarditis to a tertiary cardiology center between January 2014 and January 2024. Diagnosis was established according to ICD-10 criteria with confirmation by CMR. The primary endpoint was recurrent myocarditis at two-year follow-up. Independent predictors were delineated through binary logistic regression and time-to-event analyses using multivariate Cox proportional hazards modeling. Results: The two-year recurrence rate was 12.3%, with a median time to recurrence of 13.5 months. Time of colchicine use, ST-segment depression on the admission electrocardiogram (OR 14.469, 95%CI 2.416–86.673; p = 0.003), and late gadolinium enhancement (LGE) on CMR (OR 10.362, 95%CI 1.614–66.549; p = 0.014) emerged as independent predictors of recurrence. Colchicine therapy sustained for a minimum of three months was independently associated with a markedly reduced recurrence risk (OR = 0.295, 95%CI = 0.098–0.891; p = 0.030). Cox regression corroborated these associations, demonstrating substantially elevated hazard ratios for ST depression (HR = 10.729, 95%CI = 2.201–52.298; p = 0.003) and LGE (HR = 8.064, 95%CI = 2.036–31.942; p = 0.003), with a protective effect of adequate colchicine duration (HR = 8.577 for treatment cessation; p = 0.025). A multisegmental LGE pattern and index episode onset during the winter months were additionally associated with recurrence. Conclusions: ST-segment depression on admission electrocardiography and CMR-detected LGE may represent potent, independent predictors of myocarditis recurrence. Adequate colchicine duration of at least three months may attenuate recurrence risk, underscoring the critical importance of optimizing anti-inflammatory therapy duration and integrating electrocardiographic and imaging phenotyping into personalized long-term surveillance strategies.

Background: Evaluating the severity of pulmonary embolism (PE) is crucial for determining the appropriate therapeutic strategy and prognosis. An electrocardiographic approach to predicting prognosis in PE may yield valuable insights. Objectives: We aimed to assess the prognostic performance of the electrical risk score (ERS) and its correlation with the PESI and sPESI scores in patients with PE. Methods: In this retrospective, single-center study, we included 131 patients presenting with PE between February 1, 2023, and September 30, 2024. Pearson correlation analysis assessed ERS' correlation with PESI and sPESI scores. Binary logistic regression and ROC analysis were used to evaluate predictors for 1-year all-cause mortality (ACM). Primary outcome was 1-year ACM. Results: A significant correlation was noted between the ERS and PESI score (r = 0.796, 95% CI=0.720-0.852), and also between the ERS and sPESI score (r = 0.566, 95%CI=0.433-0.675). In binary logistic regression analysis, ERS was an independent predictor of 1-year all-cause mortality (OR=7.562, 95%CI=1.939-29.489) and in-hospital mortality (OR=5.339, 95%CI=1.559-18.285), after adjusting for age, hypertension, troponin level, use of renin-angiotensin system inhibitors, use of diuretics, PESI, and sPESI score. ROC analysis showed that ERS exhibited a higher prognostic accuracy (AUC=0.900, 95%CI=0.818-0.982) compared to the PESI (AUC=0.771, 95%CI=0.657-0.885) and sPESI (AUC=0.620, 95%CI=0.478-0.762) scores. The optimal cut-off value of ERS for predicting 1-year ACM was 3.5 with a sensitivity of 89.5% and a specificity of 81.2%. Conclusion: Electrical risk score may yield a greater prognostic accuracy for the prediction of 1-year ACM in PE compared to the PESI and sPESI scores.

Background and Objectives: Transcatheter aortic valve implantation (TAVI) has become the mainstay of treatment for symptomatic aortic stenosis (AS) in patients over 70 years of age. It is also indicated for younger patients with significant comorbidities, for valve-in-valve interventions, and in selected patients with severe aortic insufficiency. We aimed to evaluate procedural and clinical outcomes of transfemoral TAVI performed over the course of 12 years by the same operators using different bioprosthetic valves. Materials and Methods: Between 2012 and 2023, 375 patients underwent TAVI in our clinic, with six types of bioprosthetic valves (Edwards Sapien XT, Medtronic Valves [CoreValve and Evolut R], Portico, Myval, Acurate Neo, and Direct Flow Medical). A transfemoral approach was used in all patients. The procedural and clinical outcomes were defined according to Valve Academic Research Consortium-3 (VARC-3) criteria. Results: The mean age of the patients was 78.4 ± 7.3, and their median STS score was 4.2 (2.9–5.9). Of the 375 patients, 361 had severe AS, 4 had severe aortic insufficiency, 5 were valve-in-valve, and 5 were valve-in-TAVI. Seven patients required a second valve implantation: four due to embolization of the prosthetic valve and three due to deep implantation of the prosthetic valve. Based on the VARC-3 criteria, the rates of technical success and device success were 90.4% and 85.3%, respectively. Major vascular complications were observed in 18 (4.8%) patients. Also, 42 (11.2%) patients required permanent pacemaker implantation. The incidence of moderate or worse paravalvular leak was 2.9%. The peri-procedural, 30-day, 1-year, and 5-year mortality rates were 5.1%, 4.3%, 15.2%, and 45.6%, respectively. STS scores (HR:1.129, 95%CI: 1.068–1.192, p < 0.001) and post-TAVI acute kidney injury (HR:3.993, 95%CI:1.629–9.785, p = 0.002) were detected as independent predictors of mortality in Cox regression analysis. Conclusions: This registry demonstrated the evolution of TAVI procedures at a single center over 12 years. A high level of collaboration between experienced operators and innovations in devices seem to be the key features for achieving high procedural success and low complication rates.

BACKGROUND:Bentall operation with Dacron material can lead to increased risk for cardiovascular events in a distant organ through inflammation and immune-mediated reaction. CASE SUMMARY:A 56-year-old man who had undergone a Bentall procedure with Dacron graft presented with suspicion of acute coronary syndrome 3 months later. Coronary angiography revealed extensive fibrotic process throughout all coronary arteries rather than thrombi. His eosinophil count was higher at the emergency service than in the preoperative state. Eosinophil count gradually decreased with oral corticosteroid and colchicine treatment. DISCUSSION:Our patient demonstrated a Dacron patch-triggered reaction in diffuse coronary artery disease, characterized by inflammation and immune-mediated mechanisms, leading to an elevated eosinophil count. Colchicine and oral corticosteroids can overcome eosinophilic reaction driven by Dacron graft in distant organs. Monitoring eosinophil counts can serve as an effective measure to assess the treatment response to colchicine during follow-up assessments. TAKE-HOME MESSAGES:Diffuse fibrotic thickening throughout the coronary arteries after a Bentall procedure may be caused by eosinophilic inflammation. Colchicine and oral corticosteroids may suppress the eosinophilic inflammation induced by the Dacron graft in distant organs. Eosinophil count may be monitored for the therapeutic response of long-term colchicine usage.

OBJECTIVE:The criteria for iron deficiency (ID) may encompass depleted iron stores alongside unmet iron demands by cardiomyocytes, potentially serving as predictors of adverse outcomes in patients with heart failure (HF). METHOD:We included 570 patients with HF. Based on newly proposed definitions of ID, patients were categorized into three groups: Type 1 (transferrin saturation [TSAT] < ≈15-16% with anemia), Type 2 or 3 (TSAT < ≈20% with no or mild anemia) and those meeting HF guideline-defined ID criteria. Binary logistic regression was used to identify independent predictors of one-year all-cause mortality in patients with HF. Cox proportional hazard regression was performed to assess the impact of Type 1 ID on mortality. RESULTS:Among the 570 HF patients, 175 (30.7%) had Type 1 ID, 250 (43.9%) had Type 2 or 3 ID, and 415 (72.8%) met the guideline-defined criteria for ID. One-year all-cause mortality rates were 38.3% in patients with Type 1 ID, 22.7% in those with Type 2 or 3 ID, and 26.0% in those meeting guideline ID criteria. Increased age (odds ratio [OR]: 1.054, 95% confidence interval [CI]: 1.025-1.084) and Type 1 ID (OR: 1.830, 95% CI: 1.044-3.208) were independent predictors of one-year all-cause mortality. Cox regression analysis demonstrated an increased risk of mortality in HF patients with Type 1 ID compared to those without, in both unadjusted (hazard ratio [HR]: 2.289, 95% CI: 1.644-3.186, P < 0.001) and adjusted (HR: 1.543, 95% CI: 1.070-2.225, P = 0.020) models. CONCLUSION:Type 1 ID was an independent predictor of one-year all-cause mortality in patients with HF, unlike Type 2 or 3 ID and guideline-defined ID. Patients with Type 1 ID with HF had a higher overall mortality risk compared to those without Type 1 ID.

BACKGROUND:Elevated circulating cancer antigen-125 (Ca-125) in heart failure has been proposed as a congestive and prognostic biomarker for patients with acute decompensated heart failure (ADHF). However, the relationship between circulating Ca-125 and diuretic efficiency in this population remains unknown. OBJECTIVES:We hypothesized that hospitalized ADHF patients with increased circulating Ca-125 levels are prone to high risk for the development of insufficient diuretic response. METHODS:We conducted the Receiver operator characteristics (ROC) analysis and binary logistic regression analysis to reveal the association between circulating Ca-125 level and diuretic response in hospitalized patients with ADHF. Insufficient diuretic response was defined as (1) a spot urinary Na+ <50 mEq/L in the spot urine sample collected 2 h following loop diuretic administration, and (2) <100 mL/hour diuresis after loop diuretic administration. RESULTS:In the prospective observational cohort study, we enrolled 168 hospitalized patients with ADHF. Insufficient diuretic response and worsening renal function occurred in 45 (26.8 %) and 83 (49.4 %) patients, respectively. ROC analysis revealed that the optimal cut off of Ca-125 was 97.6 U/mL with a sensitivity of 64 %, and a specificity of 78 %. Overall model quality was 0.60. Using the binary logistic regression model, Ca-125≥97.6 U/mL (OR: 6.238, 95 %CI:2.712-14.349) and creatinine (OR: 4.194, 95 %CI:1.162-15.131) were independent predictors for the development of insufficient diuretic response. CONCLUSION:In hospitalized patients with ADHF, Ca-125 ≥ 97.6 U/mL can be an effective sign in forecasting diuretic efficiency and may contribute to a better risk stratification for the development of insufficient diuretic response.

Background It is imperative to maintain the use of sodium–glucose cotransporter‐2 inhibitors (SGLT‐2is) in patients with diabetes both after the index diagnosis of heart failure (HF) and even prior to the index diagnosis of HF. We aimed to investigate whether timing of SGLT‐2 is before the index diagnosis of HF, and second, adherence to SGLT‐2is in the form of the proportion of days covered metric matter in patients with HF and diabetes. Methods and Results All‐cause death up to 7 years were evaluated in HF with diabetes from the subgroup analysis of TRends‐HF (TRends in Heart Failure in Türkiye). Patients with HF and diabetes, who were prescribed an SGLT‐2i either before or after the index diagnosis of HF were identified, categorized according to duration of exposure before the index HF diagnosis and according to proportion of days covered after the index diagnosis of HF, and compared with nonusers. There were 1 229 833 patients with HF and diabetes in the cohort. A total of 247 987 were on an SGLT‐2i and had available timing data, and 14.06% had SGLT‐2i on board before the index HF diagnosis. Median duration of SGLT‐2i exposure before the index HF diagnosis was 417 days. Prognosis was the best among patients with diabetes who were prescribed an SGLT‐2i before the index diagnosis of HF with an exposure more than median duration. Of note, among patients who were prescribed an SGLT‐2i after the index HF diagnosis; there was a numerically graded increase in all‐cause mortality rate such that a >10% decrease in SGLT‐2i proportion of days covered was associated with a 59% increase in all‐cause death (hazard ratio, 1.21–2.09). Conclusions Regardless of time or adherence, SGLT‐2is offer a remarkable all‐cause death benefit to patients with HF and diabetes. SGLT‐2is' all‐cause death benefit for patients with HF and diabetes was greatest when it was prescribed before the HF index diagnosis. Poor adherence to SGLT‐2is was associated with worsening survival in patients with HF and diabetes following the diagnosis of index HF.

Background/aim:Final diagnosis of heart failure (HF) relies on a combination clinical findings, laboratory and imaging tests. The aim of this study was to review the diagnostic approach to HF in Türkiye. Materials and methods:This study is a subanalysis of the nationwide TRends-HF study, based on anonymized data from National Electronic Database between January 1, 2016, and December 31, 2022. Variables including date of birth, sex, socioeconomic development index, place of initial HF diagnosis, comorbidities, investigations, and diagnostic procedures were reported. Laboratory variables, including complete blood count, natriuretic peptides (NP), estimated glomerular filtration rate, uric acid, electrolytes, albumin, lipid profile, ferritin and hemoglobin A1c levels, and other imaging techniques (coronary angiogram [CAG], transthoracic echocardiography [TTE], chest X-ray [CXR], etc.) during the initial diagnosis and/or follow-up of HF patients, were obtained from the National Electronic Database. The diagnostic test usage rates were analyzed according to years, geographical regions, and socioeconomic regions of Türkiye. Results:The study population consisted of 2,722,151 HF patients (51.7% female, mean age 68.33 ± 14.01 years). All HF patients had at least one electrocardiogram and one TTE examination, and all underwent routine biochemical tests at least once during the follow-up period. CXR utilization rate was 93.7%, while CAG utilization rate was 17.9%. Coronary computed tomographic angiography and cardiac magnetic resonance imaging were performed in only 1.8% and 0.3% of patients, respectively. Among all Turkish HF patients, 16.3% had at least one NP measurement. The highest rate of NP use was observed in the Central Anatolia Region (21.0%), while the lowest rate was in the Aegean Region (11.7%). NP measurement during HF diagnosis revealed a rising trend over time (12.3% in 2016 vs. 26.3% in 2021). Conclusion:The widespread use of TTE at the beginning of the diagnosis and during follow-up is important for providing quality care to HF patients in Türkiye. However, detailed laboratory tests and advanced imaging methods are not utilized sufficiently, which could lead to issues in patient management.

Background/aim:Despite Türkiye's relatively young population, there is an emerging trend of earlier diagnoses of chronic diseases, including heart failure (HF). This study aims to shed light on survival rates, potential influences of guideline-directed therapies, and sex-based differences necessitating personalized management in HF. Materials and methods:We conducted a nationwide retrospective cohort analysis of 2,722,151 patients with HF using deidentified data from the Turkish Ministry of Health's national electronic database. That cohort included 2,701,099 adult patients with HF. Adult patients were divided into two groups based on their outcomes as those who were deceased and those who survived and were then compared. Multivariate regression analysis was conducted to identify variables predicting mortality. The patients' hospital admissions and length of hospital stay were analyzed based on survival status and age. Results:Out of 2,722,151 HF patients, the overall mortality rate was 33.7%, with a difference observed according to sex (32.5% in female patients, 35.0% in male patients). Survival rates at 1, 5, and 7 years after the HF diagnosis were detailed. Deceased HF patients had more comorbidities, higher natriuretic peptides, and lower glomerular filtration rates. Hospitalization patterns varied, with 41% experiencing no hospitalization. The average length of hospital stay in 2022 was 6 days, with sex- and age-specific disparities. Conclusion:The survival rate of HF in Türkiye is similar to world data. The survival of female patients is better than that of male patients. Increased survival rates can likely be attributed to the widespread use of guideline-directed therapies. Finally, high healthcare utilization is observed, especially in emergency situations.

In the contemporary management of heart failure with reduced ejection fraction (HFrEF), the recommended quadruple guideline-directed medical therapy (GDMT) consists of angiotensin receptor-neprilysin inhibitor (ARNI), evidence-based beta-blockers (BB), mineralocorticoid receptor antagonists (MRA), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i). This study explored the impact of adding implantable cardioverter-defibrillator (ICD) therapy to this comprehensive regimen in HFrEF patients. Utilizing deidentified data from the National Electronic Database of the Turkish Ministry of Health, we conducted a nationwide retrospective cohort study on 5450 HFrEF patients receiving quadruple GDMT, including ARNI. Among them, 709 patients underwent additional ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantation. Propensity score matching ensured balanced baseline characteristics between groups. Primary endpoint was determined as all-cause mortality. In the matched cohort, all-cause mortality occurred in 108 out of 619 patients (17.4

Background/aim:The epidemiological data on heart failure (HF) vary between regions within the same country. We aimed to investigate the epidemiological data on HF in Türkiye across all age groups regarding seven geographical regions. Materials and methods:We included all patients from the Turkish population who received a first diagnosis of HF between January 1, 2016 and December 31, 2022, using ICD-10 codes from the National Electronic Healthcare Database. The data were categorized by seven geographical regions of Türkiye. Results:The median age of index diagnosis of HF was 70 (60-78) years in all age groups and 4 (1-12) years in pediatric population. The prevalence rate of HF was the highest in the Black Sea Region at 3.103%, while the Southeastern Anatolia Region exhibited the lowest at 1.436%. In all age groups, female patients with HF were older and had a higher prevalence rate across all geographical regions than male patients. From 2017 to 2021, incidence rates of HF declined to 3.0 per 1000 person years, with a consistent decrease for each geographical region. The highest incidence rates of HF were seen in the Black Sea Region, while the Southeastern Anatolia Region had the lowest. Evaluating pediatric population with HF, prevalence of HF was 0.81 per 1000 people (female children: 0.77 per 1000 people, male children: 0.84 per 1000 people). Female children with HF demonstrated the highest prevalence in the Central Anatolia Region with a rate of 1.04 per 1000 people, while male pediatric population with HF exhibited the greatest prevalence of HF in the Mediterranean Region, reaching 0.89 per 1000 people. The lowest prevalence of children with HF in both sexes was observed in the Eastern Anatolia Region (female children: 0.62 per 1000 people, male children: 0.48 per 1000 people). Conclusion:Despite regional variations, prevalence of HF in Türkiye's regions aligns with global trends. Sex-based differences in HF prevalence were evident across all age groups, including pediatric population. Incidence rates of HF in each region exhibited a substantial decline by 2021.

BACKGROUND:Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are breakthrough agents for the treatment of type 2 diabetes mellitus (T2DM) and heart failure (HF). However, among patients with HF and T2DM, some uncertainty remains about individual comparisons, including dosing. OBJECTIVES:We aimed to make a real-life individual comparison of SGLT2is among patients with HF and T2DM. METHODS:This was a subgroup analysis of the Turkish Ministry of Health's National Electronic Database for adult patients with HF (TRends-HF). All-cause mortality (ACM) data up to 7 years were evaluated. Patients with HF and T2DM who were prescribed an SGLT2i were identified, and individual doses of empagliflozin 25 mg, empagliflozin 10 mg, and dapagliflozin 10 mg were compared. For individual comparisons, propensity score-matching analysis was generated as 1:1:1, and disease-modifying therapies (DMTs) for HF were considered. RESULTS:In the triple-matched cohort, 1-, 5-, and 7-year survival rates were 95%, 81%, and 76% versus 94%, 78%, and 72% versus 94%, 80%, and 75% for empagliflozin 25 mg, empagliflozin 10 mg, and dapagliflozin 10 mg, respectively. Among patients who were on triple DMT for HF, 1-, 5-, and 7-year survival rates were 95%, 78%, and 70% for empagliflozin 25 mg, 95%, 74%, and 66% for empagliflozin 10 mg, and 94%, 77%, and 69% for dapagliflozin, respectively. Annual emergency department visits were slightly lower with empagliflozin 10 mg and dapagliflozin 10 mg than with empagliflozin 25 mg. A greater proportion of patients on dapagliflozin 10 mg did not experience hospitalization during the 7-year follow-up compared with both doses of empagliflozin, albeit with a small effect size. CONCLUSION:Among patients with HF and T2DM, SGLT2is are instrumental, and empagliflozin 10 mg remains significantly inferior to dapagliflozin 10 mg and empagliflozin 25 mg in terms of 5- and 7-year ACM.