SGLT2 inhibitor therapy in patients with acute Takotsubo syndrome
Abstract
takotsubo syndrome (TTS) is an acute heart failure (HF) condition characterized by transient systolic dysfunction, myocardial edema and absent myocardial scarring. Despite recovery of left ventricular ejection fraction (LVEF), short- and long-term prognosis is similar to that of patients with acute myocardial infarction and specific treatments are currently lacking. The SGLT2 inhibitors Dapagliflozin and Empagliflozin are drugs with a recent guideline indication in acute and chronic HF, however, data specifically on TTS patients are not available. The aim of the present study was to investigate the effects of SGLT2 inhibitors in the treatment of patients hospitalized for acute TTS.
consecutive TTS patients who initiated an SGLT2 inhibitor at hospital admission were propensity-score matched (PSM) in a 1:2 ratio with untreated TTS from our historical cohort. All patients underwent a timely CMR imaging with T2 mapping assessment within 1 week of hospitalization (median 5 days, interquartile range 3, 6 days). PSM was performed including variables known to be associated with time to recovery of systolic function and edema extent.
the final analysis included n=22 TTS patients treated with an SGLT2 inhibitor (age 75±8 years; 91% female – n=13 treated with Dapagliflozin and n=9 with Empagliflozin) and n=44 untreated matched TTS. Standardized mean difference for all PSM matching variables (age, sex, presence of coronary artery disease, malignancy, neurological conditions, admission…
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: 44 participants or records.
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