Empagliflozin Use in Cardiac Transplant Patients:

Objectives: Sodium-glucose transport protein 2 (SGLT2) inhibitors are used in the treatment of patients with type 2 diabetes. Besides their beneficial metabolic effects, such as lowering glycated haemoglobin, body weight and blood pressure, these agents have shown favourable and protective effects on both the heart and kidneys. Notably, these cardio-renal benefits are even seen in individuals without diabetes. However, there is limited evidence regarding the safety and efficacy of SGLT2 inhibitors in cardiac transplant recipients. This study aimed to assess the safety and efficacy of empagliflozin in cardiac transplant recipients with diabetes. Methods: This retrospective study was conducted at the King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia, from June 2003 to May 2024. Patients from the cardiac transplant recipient register who were taking empagliflozin or a combination of empagliflozin and metformin were included. Consequently, their safety and efficacy parameters were examined. Results: A total of 20 patients were included in this study. There was an improvement in haemoglobin A1C (HbA1C) levels, body weight and stability in serum creatinine. Additionally, there was no increased risk of genitourinary infections, hypoglycaemia or diabetic ketoacidosis. Conclusions: Although larger studies are needed to examine the use of empagliflozin in cardiac transplant patients, this small study provides assurance that empagliflozin is safe for use in cardiac transplant recipients.