E-39 | Association Between Sodium-Glucose Co-Transporter 2 Inhibitor Use and 30-Day Outcomes after Transcatheter Aortic Valve Replacement: A Retrospective Matched Cohort Analysis

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) confer benefits in numerous cardiovascular conditions, including improving outcomes in those with heart failure with reduced or preserved ejection fraction and renal dysfunction. While these conditions are highly comorbid in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR), there are currently limited data on the association between SGLT2i use and TAVR outcomes. A retrospective analysis of all patients who underwent TAVR from 2020-2022 at a single center was completed. Subjects prescribed SGLT2i pre-TAVR were matched 1:4 to subjects not prescribed SGLT2i based on left ventricular ejection fraction (LVEF), age, diabetes mellitus, pre-TAVR aortic valve mean gradient, and CKD stage. Post-TAVR clinical outcomes were compared by SGLT2i status. There were 114 patients included (SGLT2i+ n=22, 75.5 ± 6.8 years, 77% male; SGLT2i- n=92, 74.8 ± 9.9 years, 80% male). There were no statistically significant differences in baseline characteristics between the matched cohorts (Table 1a). Patients in the SGLT2i cohort demonstrated higher eGFR and LVEF at 30d compared to the non-SGLT2i cohort. There were no differences in valvular parameters between groups (Table 1b). In this retrospective propensity-matched cohort analysis, SGLT2i prescription, compared to non-prescription, was associated with higher eGFR and LVEF at 30d post TAVR. Future directions include review of one-year outcomes and further analyses to determine the mechanism and long-term durability of these results.