Does SGLT2i therapy reduce sudden cardiac death, ventricular arrhythmias, and atrial arrhythmias in patients with clinical heart failure?
SGLT2 inhibitors are associated with a reduced risk of sudden cardiac death in patients with heart failure on contemporary medical therapy.
INTRODUCTION: Multiple randomized controlled trials have demonstrated sodium-glucose cotransporter-2 inhibitors (SGLT2i) decrease the composite endpoint of cardiovascular death or heart failure hospitalizations in all heart failure patients. It is uncertain whether SGLT2i impacts the risk of sudden cardiac death in patients with heart failure. METHODS: A comprehensive search was performed to identify relevant data published before August 28, 2022. Trials were included if: (1) all patients had clinical heart failure (2) SGLT2i and placebo were compared (3) all patients received conventional medical therapy and (4) reported outcomes of interest (sudden cardiac death SCD, ventricular arrhythmias, atrial arrhythmias). RESULTS: = 29%) between patients receiving an SGLT2i versus placebo. CONCLUSION: SGLT2i therapy is associated with a reduced risk of SCD in patients with heart failure receiving contemporary medical therapy. Prospective trials are needed to determine the long-term impact of SGLT2i therapy on atrial and ventricular arrhythmias.
“The decreased incidence of sudden cardiac death in patients with HF receiving SGLT2 inhibitor therapy is directly concordant with studies demonstrating that SGLT2 inhibitor therapy has a profound impact on CV death and heart failure hospitalizations in patients with heart failure regardless of ej...”
Oates et al. (Thu,) studied this question.