Abstract 4361602: SGLT2 Inhibitors in LVAD Patients: A Multi-Center Propensity-Matched Cohort Analysis
Abstract
Background:
Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are guideline-directed therapy for heart failure with reduced ejection fraction (HFrEF), yet their utility in patients supported with left ventricular assist devices (LVADs) remains understudied. This study examined the association between SGLT2i use and clinical outcomes in LVAD recipients over a standardized 1-year follow-up.
Methods:
We queried the TriNetX Global Collaborative Network to identify adult patients with an LVAD (ICD-10 Z95.811 and procedure codes for insertion/revision). Patients were stratified based on exposure to SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin, ertugliflozin) post-implant. The primary outcome was all-cause mortality at 1 year. Secondary outcomes included hospitalizations, acute kidney injury (AKI), bloodstream infections (MSSA/MRSA), and device-related complications. Propensity score matching (1:1) was performed on demographics, comorbidities, and background medical therapy. Kaplan-Meier survival analysis was used to compare time-to-event outcomes.
Results:
After matching, 711 patients were included in each cohort. At 1 year, mortality was significantly lower in the SGLT2i group (8.0% vs. 24.2%; HR: 0.28 [95% CI: 0.21–0.38];
p
<0.001). SGLT2i use was also associated with reduced hospitalization (62.3% vs. 70.7%; HR: 0.59;
p
<0.001), AKI (43.6% vs. 58.2%; HR: 0.56;
p
<0.001), and bloodstream infections (10.7% vs. 15.7%; HR: 0.59;
p
=0.002). The SGLT2i group had a…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 711 participants or records.
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