ArticleFrontiers in pharmacology2026
SGLT2 inhibitors and outcomes in the chronic Post-LVAD phase: a multicenter real-world cohort study.
Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with left ventricular assist devices (LVAD) remains uncertain. We evaluated the association between SGLT2i use and adverse outcomes during the chronic post-LVAD phase. Methods: We conducted a retrospective cohort study using the TriNetX network. Adults with LVAD implantation (2014-2025) who survived ≥90 days were included. SGLT2i exposure (empagliflozin or dapagliflozin) was identified by prescription records. A prespecified 90-day delayed outcome window defined follow-up from 3 months to 1 year after the index date. The primary outcome was a composite of all-cause mortality or heart failure exacerbation (HFE). Secondary outcomes included HFE, all-cause mortality, and major adverse kidney events (MAKE). Propensity score matching (1:1) and Cox regression were applied. Results: After matching, 1,318 patients were included in each group. SGLT2i use was associated with a lower risk of the primary composite endpoint (20.0% vs. 30.6%; HR 0.65; 95% CI 0.56-0.76; p < 0.001). Risks of HFE (18.4% vs. 26.9%; HR 0.69; p < 0.001), all-cause mortality (4.2% vs. 7.3%; HR 0.60; p = 0.002), and MAKE (27.5% vs. 35.1%; HR 0.81; p = 0.003) were also lower. Safety outcomes were similar, including urinary tract infection (HR 0.69; p = 0.091) and diabetic ketoacidosis (HR 1.25; p = 0.437). Conclusion: SGLT2i use was associated with lower risks of cardiovascular and kidney events in patients during the chronic post-LVAD phase, without increased adverse events. These findings support further evaluation of SGLT2i as part of long-term management after LVAD.
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