Heart failure & cardiomyopathies
Meta-Analysis of SGLT2 Inhibitors in Transthyretin Cardiac Amyloidosis: Insights by Disease-Modifying Therapy
Authors' conclusion
In observational studies, SGLT2i therapy in ATTR-CM is associated with lower all-cause mortality and HF hospitalizations. These findings are clinically encouraging, particularly for patients not receiving DMT, in whom therapeutic options remain limited. Prospective randomized trials are warranted to confirm these findings and better define SGLT2i benefit according to DMT.
Study context
- Population
- Patients with transthyretin cardiac amyloidosis (ATTR-CM)Fourteen observational studies, 5.453 patients received SGLT2i
- Participants
- 10.852 patients
- Comparison
- SGLT2i in ATTR-CM, stratified by disease-modifying therapy (DMT)
- SGLT2in = 5.453
- Outcome
- All-cause mortality and HF hospitalization
Methodological detailsobservational studies
- Observational studies
Pooled result
As reported in the abstract
Risk ratio
0.44
P < 0.001
all-cause mortality; lower risk; k = 6; n = 5.135; I2 = 53.9%; 2 studies reported zero events (k = 4; n = 5.038)
Hazard ratio
0.62
P < 0.001
Heart failure (HF) hospitalization; reduced; k = 2; n = 1.438; I2 = 0%
Further pooled results
Study characteristics
- Had diabetes
- 43.6%
- Of 7.708 patients (k = 12) with known DMT status, received DMT
- 34.6%
- Follow-up
- 3 months to 5.5 years
Subgroup analyses by DMT and diabetes status
- Consistent direction of association
- Findings require further validation
Safety
Pooled prevalence of adverse events
- Pooled prevalence (k = 7; n = 535)
- 7.28%
- I2 = 76.6%
Original publication
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