Heart failure & cardiomyopathiesCohort study
SGLT2 Inhibitor Therapy in Patients With Transthyretin Amyloid Cardiomyopathy
- Retrospective cohort study
- propensity-score matched
- consecutive patients
Authors' conclusion
SGLT2i treatment in ATTR-CM patients was well tolerated and associated with favorable effects on HF symptoms, renal function, and diuretic agent requirement over time. SGLT2i treatment was associated with reduced risk of HF hospitalization and cardiovascular and all-cause mortality, regardless of the ejection fraction, despite the effect size being likely overestimated.
Study context
- Population
- Patients with transthyretin amyloid cardiomyopathy (ATTR-CM), 2014–2022260 (11%) received SGLT2i
- Participants
- 2,356 patients
- Exposure
- SGLT2i vs no SGLT2i
- SGLT2in = 220
- Controln = 220reference
Main finding
As reported in the abstract
All-cause mortality, CV mortality, heart failure (HF) hospitalization, composite of CV mortality and HF hospitalization · 28 months (Q1-Q3: 18-45 months)
SGLT2i vs ControlHazard ratio (95% CI)P value
all-cause mortality
0.57(0.37–0.89)
P = 0.010CV mortality
0.41(0.24–0.71)
P < 0.001HF hospitalization
0.57(0.36–0.91)
P = 0.014CV mortality and HF hospitalization
0.57(0.38–0.84)
P = 0.003Observational data: associations, not effects.
Further findings
NYHA class, NT-proBNP, eGFR, new loop diuretic initiation · 12 months
- SGLT2i associated with less worsening of NYHA class, NT-proBNP, eGFR, and fewer new loop diuretic initiations
Safety
- SGLT2i discontinuation
- 4.5%
Original publication
SGLT2 Inhibitor Therapy in Patients With Transthyretin Amyloid Cardiomyopathy. J Am Coll Cardiol. Published 18 June 2024. doi:10.1016/j.jacc.2024.03.429
Summarised from the published abstract; every number is checked against it