{
  "abstract": "Sodium–glucose cotransporter-2 inhibitors (SGLT2i) improve outcomes across several cardiometabolic conditions, but their role in World Health Organization group 1 pulmonary arterial hypertension (PAH) remains uncertain. We conducted a retrospective, single-center cohort study of adults with group 1 PAH. Patients prescribed SGLT2i were compared with patients without exposure. Propensity-score matching was performed 1:2 using age, sex, baseline REVEAL Lite 2 risk category, diabetes mellitus, and statin use. The primary outcome was all-cause mortality, and the secondary outcome was major adverse cardiovascular events. Associations were evaluated using fixed-exposure and start–stop time-varying Cox models. The matched cohort included 366 patients: 122 (33%) receiving SGLT2i and 244 (67%) controls. Most patients were classified as high risk by REVEAL Lite 2 (106 SGLT2i recipients (87%) and 215 controls (88%), respectively). In the fixed-exposure analysis, SGLT2i use was associated with lower mortality (hazard ratio [HR], 0.53; 95% CI, 0.31-0.91; P =.018), without a significant difference in major adverse cardiovascular events (HR, 1.23; 95% CI, 0.93-1.63; P =.14). In the time-varying analysis, SGLT2i exposure was not significantly associated with mortality (HR, 0.74; 95% CI, 0.26-2.11; P =.57). The apparent survival association was attenuated after accounting for treatment timing, demonstrating the sensitivity of observational PAH estimates to exposure classification and supporting prospective randomized trials.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ"
  ],
  "article_type": "brief report",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Abdelrahman Hafez, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Amal Youssef, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Mohamed Nour, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Juan M. Farina, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Kamal Awad, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Milagros Pereyra Pietri, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Isabel G. Scalia, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Fatmaelzahraa Abdelfattah, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Mahshad Razaghi, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Laurève Chollet, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Sherif Ahmed, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Ramzi Ibrahim, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Nikita Rafie, MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Robert L. Scott, MD, PhD"
    },
    {
      "affs": [
        0
      ],
      "name": "Chadi Ayoub, MBBS, PhD"
    },
    {
      "affs": [
        0
      ],
      "name": "Reza Arsanjani, MD"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9a3pacbs8916r.bib",
  "cited_by": 0,
  "doi": "10.1016/j.mayocpiqo.2026.100765",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S254245482600072X",
  "id": "9a3pacbs8916r",
  "issns": [
    "2542-4548"
  ],
  "landing_url": "https://doi.org/10.1016/j.mayocpiqo.2026.100765",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Brief Report"
    ],
    [
      "lcc",
      "R5-920"
    ],
    [
      "openalex",
      "2740|Pulmonary Hypertension Research and Treatments"
    ]
  ],
  "openalex": "W7223112545",
  "pdf_url": "https://www.mcpiqojournal.org/article/S2542-4548(26)00072-X/pdf",
  "pmcid": null,
  "pmid": "42960257",
  "published": "2026-10-21",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/9a3pacbs8916r.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:43:44Z",
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      "url": "https://doi.org/10.1016/j.mayocpiqo.2026.100765"
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    {
      "first_seen": "2026-11-02T12:22:46Z",
      "native_id": "PMC13718806",
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      "url": "https://doi.org/10.1016/j.mayocpiqo.2026.100765"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Pulmonary Hypertension Research and Treatments",
      "subfield": "general"
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  ],
  "title": "Sodium–Glucose Cotransporter-2 Inhibitors in World Health Organization Group 1 Pulmonary Arterial Hypertension: A REVEAL Lite 2–Matched Cohort With Time-Varying Exposure Analysis",
  "title_text": "Sodium–Glucose Cotransporter-2 Inhibitors in World Health Organization Group 1 Pulmonary Arterial Hypertension: A REVEAL Lite 2–Matched Cohort With Time-Varying Exposure Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:22:46Z",
  "url": "https://research.draconitic.com/paper/9a3pacbs8916r",
  "venue": "Mayo Clinic Proceedings: Innovations, Quality & Outcomes",
  "versions": []
}