Early sodium-glucose cotransporter-2 inhibitor use after Takotsubo syndrome was associated with lower all-cause mortality (8.1% vs 13.6%; HR 0.71; 95% CI 0.58-0.87; p=0.001).
Cohort (n=3,606)
Yes
Does early sodium-glucose cotransporter-2 inhibitor initiation reduce all-cause mortality in adults with incident Takotsubo syndrome?
Early initiation of SGLT2 inhibitors after Takotsubo syndrome is associated with reduced all-cause mortality, suggesting a potential therapeutic role in a condition where pharmacologic management remains empirical.
Hazard Ratio: 0.71 (95% CI 0.58–0.87)
Absolute Event Rate: 8.1% vs 13.6%
p-value: p=0.001
Pharmacologic management after Takotsubo syndrome (TTS) remains empirical. We evaluated whether early sodium-glucose cotransporter-2 inhibitor initiation after TTS was associated with clinical outcomes in a large real-world cohort. Using the TriNetX US Collaborative Network, we identified adults with incident TTS from 2015 to 2025. Patients initiated on a sodium-glucose cotransporter-2 inhibitor within 14 days were propensity-matched 1:1 to patients without early sodium-glucose cotransporter-2 inhibitor use. Follow-up for time-to-event analyses began on day 14. The primary outcome was all-cause mortality. Secondary outcomes were heart failure hospitalization, cardiogenic shock, cardiac arrest, and major adverse cardiovascular events. A total of 54,701 patients with TTS, 1,803 matched pairs were analyzed. Early sodium-glucose cotransporter-2 inhibitor use was associated with lower all-cause mortality (8.1% vs 13.6%; hazard ratio 0.71; 95% confidence interval 0.58 to 0.87; p = 0.001). Associations were not significant for heart failure hospitalization, cardiogenic shock, cardiac arrest, or major adverse cardiovascular events. Mortality findings were directionally consistent in sensitivity analyses excluding patients with COVID-19 and, separately, diabetes mellitus. In this observational landmark analysis, early sodium-glucose cotransporter-2 inhibitor use after TTS was associated with lower all-cause mortality but not lower cardiovascular event rates.
Taha et al. (Fri,) conducted a cohort in Takotsubo syndrome (n=3,606). Sodium-glucose cotransporter-2 inhibitor vs. No early sodium-glucose cotransporter-2 inhibitor use was evaluated on all-cause mortality (HR 0.71, 95% CI 0.58 to 0.87, p=0.001). Early sodium-glucose cotransporter-2 inhibitor use after Takotsubo syndrome was associated with lower all-cause mortality (8.1% vs 13.6%; HR 0.71; 95% CI 0.58-0.87; p=0.001).