{ "abstract": "Background/Objectives: Acute heart failure (AHF) is the leading cause of hospitalization among patients over 65 years and is frequently associated with frailty. Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) currently represent the only drug class recommended across the entire ejection fraction spectrum, although evidence regarding their effectiveness according to frailty status remains limited. Aims: To determine whether functional frailty, measured by the Short Physical Performance Battery (SPPB) test, influences the effectiveness of SGLT2i in reducing hospital readmission and mortality in elderly patients with AHF. Methods: Observational study of 794 polypathological patients admitted to Internal Medicine with AHF. An interaction analysis assessed whether SPPB, as a continuous variable, modified the association between SGLT2i and the composite outcome (hospital readmission or death), using a Cox model. The sample was further divided by SPPB test score (below 4 (N = 477) or ≥4 (N = 317)) for exploratory analyses. Descriptive and comparative analyses were performed according to SGLT2i administration, using the chi-squared test for qualitative variables and Student’s t-test for quantitative ones (Fisher’s and Mann–Whitney U test as appropriate). Survival analysis was done using Kaplan–Meier curves and Cox regression, with multivariable adjustment for confounders. Results: No significant interaction was found between SPPB score and SGLT2i (p = 0.506). When SPPB was dichotomised, SGLT2i treatment was associated with significantly lower all-cause mortality (3.7% vs. 12.0%; p = 0.018) and readmission (30.3% vs. 45.2%; p = 0.021) in SPPB ≥ 4, with mortality and readmission also numerically lower, without reaching statistical significance, in SPPB < 4 (mortality 12.9% vs. 16.9%, p = 0.410; readmission 34.5% vs. 42.0%, p = 0.220). After adjustment, SGLT2i treatment in the SPPB ≥ 4 group remained associated with a numerically lower hazard for the composite outcome (HR 0.652; 95% CI 0.418–1.018; p = 0.060). Conclusions: No evidence was found that functional frailty modifies the effectiveness of SGLT2i in elderly polypathological patients with AHF. An exploratory analysis suggested a possible gradient of greater association with SPPB ≥ 4, although this should be interpreted as hypothesis-generating.", "abstract_shown": true, "affiliations": [ "Department of Internal Medicine, Hospital Clínico San Carlos, 28040 Madrid, Spain", "Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain", "Health Research Institute, Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain", "Research Methodological Support Unit and Preventive Department, Hospital Clínico San Carlos, 28040 Madrid, Spain", "Department of Internal Medicine, Complejo Asistencial de Ávila, 05071 Ávila, Spain", "Department of Internal Medicine, Hospital 12 de Octubre, 28041 Madrid, Spain", "Department of Internal Medicine, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France" ], "article_type": "research article", "arxiv": null, "author_total": 11, "authors": [ { "affs": [ 0, 1, 2 ], "name": "Alicia Guzmán-Carreras", "orcid": "0009-0002-6509-2906" }, { "affs": [ 0, 2 ], "name": "Purificación Romero-Jiménez" }, { "affs": [ 0, 2 ], "name": "Sahar Okab" }, { "affs": [ 2, 3 ], "name": "Rafael Sánchez-del Hoyo", "orcid": "0000-0002-3462-4183" }, { "affs": [ 4 ], "name": "Aladin Abdelhady Kishta-Kishta", "orcid": "0009-0007-6422-1282" }, { "affs": [ 4 ], "name": "Juan Igor Molina-Puente" }, { "affs": [ 5 ], "name": "Fernando Aguilar-Rodríguez", "orcid": "0000-0002-8882-341X" }, { "affs": [ 6 ], "name": "Noel Lorenzo-Villalba" }, { "affs": [ 6 ], "name": "Emmanuel Andrès", "orcid": "0000-0002-7914-7616" }, { "affs": [ 0, 2 ], "name": "María del Rosario Iguarán-Bermúdez" }, { "affs": [ 0, 1, 2 ], "name": "Manuel Méndez-Bailón", "orcid": "0000-0003-0830-8897" } ], "bibtex": "https://research.draconitic.com/paper/71p3v1tq6y2jh.bib", "cited_by": 0, "doi": "10.3390/jcm15207769", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705070/?tool=EBI", "id": "71p3v1tq6y2jh", "issns": [ "2077-0383" ], "landing_url": "https://www.mdpi.com/2077-0383/15/20/7769", "language": "eng", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2705|Heart Failure Treatment and Management" ] ], "openalex": "W7221159583", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705070/pdf/?tool=EBI", "pmcid": "PMC13705070", "pmid": null, "published": "2026-10-01", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/71p3v1tq6y2jh.ris", "sources": [ { "first_seen": "2026-10-30T12:20:00Z", "native_id": "10.3390/jcm15207769", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/20/7769" }, { "first_seen": "2026-10-30T12:21:47Z", "native_id": "PMC:PMC13705070", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13705070" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2705|Heart Failure Treatment and Management", "subfield": "cardiovascular" } ], "title": "Impact of Functional Frailty Measured by Short Physical Performance Battery Test on the Effectiveness of SGLT2 Inhibitors in Elderly Patients with Acute Heart Failure:PROFUND-IC Registry", "title_text": "Impact of Functional Frailty Measured by Short Physical Performance Battery Test on the Effectiveness of SGLT2 Inhibitors in Elderly Patients with Acute Heart Failure:PROFUND-IC Registry", "type": "peer-reviewed", "updated_at": "2026-10-30T12:21:47Z", "url": "https://research.draconitic.com/paper/71p3v1tq6y2jh", "venue": "Journal of Clinical Medicine", "versions": [] }