Exploring the Safety of Sodium-Glucose Co-Transporter 2 Inhibitors in Left Ventricular Assist Device Patients: Clinical Outcomes in a Multicenter Experience

Heart failure (HF) remains a progressive condition even with optimal medical therapy, often requiring advanced interventions like left ventricular assist devices (LVAD). Recent advancements in HF treatment, including sodium-glucose co-transporter 2 inhibitors (SGLT2i), have demonstrated benefits such as reduced mortality, symptom improvement, and renal protection. Their effects in LVAD patients remain unexplored. This study aims to evaluate the safety and therapeutic potential of SGLT2i in LVAD recipients, addressing a critical gap in current knowledge. A retrospective analysis of 176 consecutive patients who underwent LVAD implantation at two major academic centers in Germany (2018–2023) was conducted. In 139 LVAD patients (58 SGLT2i vs. 81 controls), we compared clinical and laboratory parameters at 6 and 12 months. In an additional group of 37 SGLT2i naïve patients who were already established on LVAD support the clinical course was compared to the pre-SGLT2i era. Renal function and cardiac biomarkers were not negatively affected during the first year of SGLT2i use. Complication rates ( eg , infections, hypovolemic events, acute kidney injury) were comparable to both the control group and pre-SGLT2i era. Sodium-glucose co-transporter 2 inhibitors as part of contemporary HF medication appear to be safe for LVAD patients. Further research and longer follow-up periods are necessary to draw robust conclusions on cardiovascular and renal outcomes.