Key result
SGLT2 inhibitors reduce 1-year mortality or HF hospitalization ~25% after TAVR.
Why the study?
SGLT2 inhibitors improve cardiovascular outcomes in heart failure and type 2 diabetes, but their effect in patients undergoing TAVR for severe aortic stenosis remains unclear.
Does SGLT2 inhibitor therapy reduce the composite of all-cause mortality or heart failure hospitalization in patients with severe aortic stenosis undergoing TAVR?
Meta-Analysis (n=3,187)
Yes
Does SGLT2 inhibitor therapy reduce the composite of all-cause mortality or heart failure hospitalization in patients with severe aortic stenosis undergoing TAVR?
SGLT2 inhibitors demonstrated a significant reduction in the composite of all-cause mortality and heart failure hospitalisation following TAVR, highlighting a potential disease-modifying role for adjunctive pharmacotherapy in this population.
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May support SGLT2 inhibitor use after TAVR; leaves open confirmation in randomized trials for severe aortic stenosis.
Sodium‐glucose cotransporter 2 (SGLT2) inhibitors improve cardiovascular (CV) outcomes in patients with heart failure (HF) and type 2 diabetes. Their effect in patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS), however, remains unclear. This study evaluated whether SGLT2 inhibitors reduce all‐cause mortality and HF hospitalisations after TAVR. A systematic search of PubMed, ScienceDirect, Cochrane (CENTRAL), Scopus and Embase was performed through April 2025 for studies comparing post‐TAVR outcomes between SGLT2 inhibitor users and non‐users. Outcomes of interest included a composite of all‐cause mortality or heart failure (HF) hospitalisation, along with the individual components of all‐cause mortality and HF hospitalisation. All outcomes were extracted at 1 year. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random‐effects model. Heterogeneity was quantified using I 2 statistics. Analyses were conducted in R (version 4.4.2). Three studies (1 RCT, 2 Observational) comprising 3187 patients met inclusion criteria. SGLT2 inhibitor use was associated with a reduced risk of the composite outcome (HR: 0.75; 95% CI: 0.65, 0.86; p < 0.01). Individually, therapy lowered all‐cause mortality (HR: 0.72; 95% CI: 0.53, 0.96; p = 0.03) and HF hospitalisations (HR: 0.74; 95% CI: 0.61, 0.90; p < 0.01). In patients with severe AS undergoing TAVR, SGLT2 inhibitors were associated with significant reductions in all‐cause mortality and HF hospitalisations. These findings suggest a promising role for SGLT2 inhibitors in improving post‐TAVR outcomes. However, given the limited data, larger randomised clinical trials are necessary to consolidate these findings. Trial Registration: CRD420251132729 Keywords: aortic stenosis, heart failure, meta‐analysis, sodium‐glucose cotransporter 2 inhibitors, transcatheter aortic valve replacement
Daniyal et al. (2026) conducted a meta-analysis in Severe aortic stenosis undergoing TAVR (n=3,187). SGLT2 inhibitors vs. Non-SGLT2 inhibitor use (standard care alone) was evaluated on Composite of all-cause mortality or heart failure hospitalisation at 1 year (HR 0.75, 95% CI 0.65-0.86, p=<0.01). SGLT2 inhibitor therapy reduced the composite risk of all-cause mortality or heart failure hospitalisation by 25% (HR 0.75) compared to non-users following TAVR.
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