Key result
In oncology patients at high risk of cardiovascular toxicity, SGLT2 inhibitors added to cardioprotective therapy maintained stable left ventricular ejection fraction and global longitudinal strain at 6 months (p>0.05).
Why the study?
Cardiotoxicity is a major limitation of anticancer therapies, and the potential cardioprotective benefits of SGLT2 inhibitors in oncology patients at risk of CTR-CVT require evaluation.
Does the addition of SGLT2 inhibitors to cardioprotective therapy prevent echocardiographic and renal changes in oncologic patients at high risk of CTR-CVT?
Cohort (n=70)
Does the addition of SGLT2 inhibitors to cardioprotective therapy prevent echocardiographic and renal changes in oncologic patients at high risk of CTR-CVT?
p-value: p=>0.05
In a hypothesis-generating prospective cohort, the addition of SGLT2 inhibitors to standard cardioprotective therapy in high-risk oncology patients showed trends toward stabilizing echocardiographic and renal parameters over 6 months without adverse cardiac effects.
Introduction Cardiotoxicity remains a major limitation of contemporary anticancer therapies. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiovascular benefits, including reduced heart failure hospitalizations, and emerging evidence suggests potential additional benefits in oncology populations. Accurate baseline cardiovascular risk stratification and early initiation of cardioprotective therapy are essential for preventing cancer therapy–related cardiovascular toxicity (CTR-CVT). Methods We prospectively evaluated 256 patients with breast or lung cancer prior to initiation of anticancer therapy. Baseline cardiovascular assessment included echocardiography with biplane left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), diastolic function, and measurement of cardiac biomarkers (troponin and NT-proBNP). Cardiovascular history, demographic data, and risk factors were collected. CTR-CVT risk was assessed using the HFA-ICOS Cardio-Oncology risk assessment tool.Seventy patients (29 men, 41 women; mean age 69.6 ± 8.0 years) were classified as high risk and initiated on cardioprotective therapy. Forty-seven patients (67.1%) received angiotensin-converting enzyme inhibitors, beta-blockers, statins, and SGLT2 inhibitors (SGLT2i group). Twenty-three patients (32.9%) had contraindications to SGLT2i therapy and received standard cardioprotective treatment. Outcomes were assessed at 6 months. Results At 6-month follow-up, no statistically significant changes in systolic or diastolic function were observed in either group. In the SGLT2i group, LVEF and GLS remained stable between baseline and follow-up (median LVEF 60.0% vs. 53.0%, p>0.05; GLS −18.9% vs. −16.8%, p>0.05). Renal function showed a modest numerical decline (median eGFR 80.0 vs. 62.0 ml/min/1.73 m², p>0.05). In patients not receiving SGLT2i, no significant changes were detected in LVEF or GLS, while a numerically greater decline in renal function was observed (median eGFR 95.0 vs. 49.0 ml/min/1.73 m², p>0.05). Diastolic parameters remained stable in the SGLT2i group, whereas a numerical increase in E/e′ medial was observed in the non-SGLT2i group. No heart failure–related hospitalisations or cardiovascular deaths occurred. Conclusion In this 6-month longitudinal analysis of oncologic patients at high risk of CTR-CVT, inclusion of SGLT2 inhibitors in a cardioprotective regimen was not associated with adverse cardiac effects. Although statistical significance was not reached, trends toward more stable cardiac and renal parameters were observed. These findings are hypothesis-generating and support further investigation of SGLT2 inhibitors in cardio-oncology.
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Samardjieva et al. (2026) conducted a cohort in Breast or lung cancer at high risk of cancer therapy-related cardiovascular toxicity (n=70). SGLT2 inhibitors vs. Standard cardioprotective treatment was evaluated on Echocardiographic and renal changes (LVEF, GLS, and eGFR) (p=>0.05). In oncology patients at high risk of cardiovascular toxicity, SGLT2 inhibitors added to cardioprotective therapy maintained stable left ventricular ejection fraction and global longitudinal strain at 6 months (p>0.05).
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