The Role of Sodium-Glucose Cotransporter-2 Inhibitors in Adults With Transthyretin Cardiac Amyloidosis: A Single-Center Retrospective Cohort Study
Abstract
Background: Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy with limited treatment options. Barring mineralocorticoid receptor antagonists, most classes of guideline-directed medical therapy including renin-angiotensin-aldosterone inhibitors and beta blockers are avoided in CA due to intolerance and the risk of potentiating orthostatic hypotension. Few studies have explored the safety and utility of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in CA. These agents have demonstrated benefit in most heart failure phenotypes, and individuals with CA may benefit from treatment with them. We report a single-center experience demonstrating the safety of SGLT2is in patients with cardiac amyloidosis. Methods: We conducted a retrospective study including patients with CA from January 2020 to March 2023 who were treated with empagliflozin at doses of 10 mg or 25 mg daily or dapagliflozin at a dose of 10 mg daily. Patients were monitored clinically for the development of adverse effects including urinary tract infections and orthostatic hypotension as well as through laboratory monitoring for acute kidney injury and for changes in microalbuminuria. Results: Our cohort comprised 53 patients with cardiac amyloidosis treated with an SGLT2i, 38 (72%) of whom were male, with a mean participant age of 81±8 years and left ventricular ejection fraction of 50%. Urinary tract infections were observed in three participants (6%). Acute kidney injury occurred in two participants.…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 53 participants or records.
Read the paper
Related studies
- Strategy for Mitigating DKA Risk in Patients with Type 1 Diabetes on Adjunctive Treatment with SGLT Inhibitors: A STICH Protocol
- Glucoraphanin: a broccoli sprout extract that ameliorates obesity-induced inflammation and insulin resistance
- SGLT2 Inhibitors in Heart Failure: Targeted Metabolomics and Energetic Metabolism
- Mechanisms of blood pressure reduction with sodium-glucose co-transporter 2 (SGLT2) inhibitors
- Sodium-glucose cotransporter inhibitors: beyond glycaemic control
- Decoding the effects of SGLT2 inhibitors on cardiac arrhythmias in heart failure
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.