Erythrocytosis incidence and thromboembolic risk in heart failure with reduced ejection fraction treated with SGLT2 inhibitors: a nationwide register-based cohort study
Main finding · Erythrocytosis incidenceResult — go to the resultAdjusted incidence rate ratio 4.10 95% CI 2.95–5.83Authors' conclusion
Although erythrocytosis incidence was higher in SGLT2i-treated HFrEF patients, it was not associated with an increased one-year thromboembolic risk.
Study context
- Population
- Patients with new-onset heart failure with reduced ejection fraction (HFrEF)propensity score-matched
- Participants
- 3,138 vs 3,138
- Exposure
- SGLT2i-treated vs untreated controls
- SGLT2in = 3,138
- Untreated controlsn = 3,138reference
- Outcome
- Erythrocytosis incidence (Hb >16.5 g/dL in men, >16.0 g/dL in women); association of erythrocytosis with fatal and non-fatal thromboembolic events (MI, stroke, PE or DVT)
- Follow-up
- Six-month ; one-year thromboembolic risk
Methodological detailspropensity score-matched
- Propensity score-matched
Main finding
Erythrocytosis incidence · six-month follow-up
Adjusted incidence rate ratio
4.10
95% CI 2.95–5.83
By group
SGLT2i
109.5 per 1000 person-years
Untreated controls
26.8 per 1000 person-years
SGLT2ivs Untreated controls
adjusted incidence rate ratio 4.10 (95% CI 2.95–5.83)
As reported in the abstract
- Erythrocytosis developed (total)
- 207 patients (3.3%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| One-year thromboembolic risk, erythrocytosis vs noneErythrocytosisvs No erythrocytosisTotal population | 0.85 (0.44–1.65) | ||
| One-year thromboembolic risk, erythrocytosis vs noneErythrocytosisvs No erythrocytosisSGLT2i-treated | 0.81 (0.38–1.74) | ||
| One-year thromboembolic risk, erythrocytosis vs noneErythrocytosisvs No erythrocytosisUntreated | 0.75 (0.19–3.05) | interaction P = 0.77 | |
| 0.20.5125Hazard ratio (log scale) |
One-year thromboembolic risk, erythrocytosis vs none
- No significant association between erythrocytosis and one-year thromboembolic risk
Original publication
Erythrocytosis incidence and thromboembolic risk in heart failure with reduced ejection fraction treated with SGLT2 inhibitors: a nationwide register-based cohort study. Cardiovasc Diabetol. Published 1 August 2025. doi:10.
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