Clinical Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors After Transcatheter Aortic Valve Replacement in Patients With Diabetes: A Global Retrospective Study
- 1Department of Medicine, SUNY Upstate Medical University, Syracuse, New York
Abstract
Background: Transcatheter aortic valve replacement (TAVR), a standard therapy for aortic stenosis, is preferred for older or high-risk patients. Various complications, including heart failure (HF), resulting in increased mortality, have been reported in the literature. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are recommended in HF, irrespective of ejection fraction; however, their role in reducing post-TAVR cardiovascular complications remains underexplored. We conducted a retrospective study to evaluate cardiovascular outcomes associated with the use of SGLT2i in post-TAVR patients.
Methods: This retrospective cohort was based on a global database of electronic health records of more than 160 million patients. After propensity-score matching, the study population included 9930 post-TAVR diabetic patients divided into 2 cohorts based on their exposure to SGLT2i. Exposure to SGLT2i was defined as exposure after 1 day of TAVR.
Results: In this study of 9930 post-TAVR diabetic patients, the primary outcome of major adverse cardiovascular events and secondary outcomes, ie, cardiovascular mortality, ischemic stroke, and HF exacerbation, were significantly reduced in SGLT2i-exposed post-TAVR patients at the 1-month and 1-year follow-up. Hemorrhagic stroke was comparable at the 1-month follow-up; however, it was significantly lower in SGLT2i-exposed cohorts at the 1-year follow-up. The risk of new-onset myocardial infarction was significantly reduced at 1 month; however, it was comparable between the 2 cohorts at the 1-year follow-up. Our study also demonstrated a significant reduction in the risk of end-stage renal disease in the SGLT2i-exposed cohort at the 1-year follow-up. The periprocedural risk of acute kidney injury (within 7 days of TAVR) as well as at the 1-month and 1-year follow-up was significantly lower in the SGLT2i-exposed cohort.
Conclusions: In this study, post-TAVR SGLT2i use in diabetic patients was associated with reduced cardiovascular morbidity and mortality for up to 1 year.
Related
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BibTeX
@article{hanif2026clinical,
title = {{Clinical Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors After Transcatheter Aortic Valve Replacement in Patients With Diabetes: A Global Retrospective Study}},
author = {Muhammad Hanif and Waasay H. Khan and Shiva P. Sah and Jai S. Nagarajan and Jenish Bhandari and Stephen J. Knohl and Cynthia C. Taub and Andrew M. Weinberg and Ankur Kalra},
journal = {Journal of the Society for Cardiovascular Angiography \& Interventions},
year = {2026},
month = aug,
doi = {10.1016/j.jscai.2026.105561},
url = {https://doi.org/10.1016/j.jscai.2026.105561},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Clinical Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors After Transcatheter Aortic Valve Replacement in Patients With Diabetes: A Global Retrospective Study
AU - Muhammad Hanif
AU - Waasay H. Khan
AU - Shiva P. Sah
AU - Jai S. Nagarajan
AU - Jenish Bhandari
AU - Stephen J. Knohl
AU - Cynthia C. Taub
AU - Andrew M. Weinberg
AU - Ankur Kalra
PY - 2026
DA - 2026/08/13
JO - Journal of the Society for Cardiovascular Angiography & Interventions
DO - 10.1016/j.jscai.2026.105561
UR - https://doi.org/10.1016/j.jscai.2026.105561
AB - Background: Transcatheter aortic valve replacement (TAVR), a standard therapy for aortic stenosis, is preferred for older or high-risk patients. Various complications, including heart failure (HF), resulting in increased mortality, have been reported in the literature. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are recommended in HF, irrespective of ejection fraction; however, their role in reducing post-TAVR cardiovascular complications remains underexplored. We conducted a retrospective study to evaluate cardiovascular outcomes associated with the use of SGLT2i in post-TAVR patients. Methods: This retrospective cohort was based on a global database of electronic health records of more than 160 million patients. After propensity-score matching, the study population included 9930 post-TAVR diabetic patients divided into 2 cohorts based on their exposure to SGLT2i. Exposure to SGLT2i was defined as exposure after 1 day of TAVR. Results: In this study of 9930 post-TAVR diabetic patients, the primary outcome of major adverse cardiovascular events and secondary outcomes, ie, cardiovascular mortality, ischemic stroke, and HF exacerbation, were significantly reduced in SGLT2i-exposed post-TAVR patients at the 1-month and 1-year follow-up. Hemorrhagic stroke was comparable at the 1-month follow-up; however, it was significantly lower in SGLT2i-exposed cohorts at the 1-year follow-up. The risk of new-onset myocardial infarction was significantly reduced at 1 month; however, it was comparable between the 2 cohorts at the 1-year follow-up. Our study also demonstrated a significant reduction in the risk of end-stage renal disease in the SGLT2i-exposed cohort at the 1-year follow-up. The periprocedural risk of acute kidney injury (within 7 days of TAVR) as well as at the 1-month and 1-year follow-up was significantly lower in the SGLT2i-exposed cohort. Conclusions: In this study, post-TAVR SGLT2i use in diabetic patients was associated with reduced cardiovascular morbidity and mortality for up to 1 year.
SN - 2772-9303
ER -