Does SGLT2i therapy reduce heart failure hospitalization and mortality in patients following transcatheter aortic valve replacement?
SGLT2 inhibitors are associated with a significant reduction in heart failure hospitalizations following TAVR, though current evidence is limited and shows no mortality benefit.
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) reduce heart failure (HF)-associated admissions; however, the data on patients with aortic stenosis following transcatheter aortic valve replacement (TAVR) is limited. This systematic review and meta-analysis compares clinical outcomes in patients with and without SGLT2i following TAVR. Major electronic databases were systematically searched through April 2025 for studies evaluating SGLT2i following TAVR. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model. A P value of ≤0.05 was considered statistically significant. Two studies with 1534 patients undergoing TAVR (679: SGLT2i; 855: no SGLT2i) were included. SGLT2i therapy led to a significant reduction in HF hospitalization (RR: 0.56; 95% CI: 0.32-0.99; P = 0.05); however, no differences in all-cause (RR: 0.48; 95% CI: 0.13-1.72; P = 0.26) and cardiovascular mortality (RR: 0.53; 95% CI: 0.19-1.48; P = 0.22) were noted. SGLT2i are associated with a statistically and clinically significant reduction in HF hospitalization; however, no reduction in mortality was observed following TAVR. Further randomized controlled trials are warranted to support future guideline recommendations regarding SGLT2i following TAVR.
Jain et al. (Tue,) studied this question.
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