J Interv Card Electrophysiol. 2025 Dec 6. doi: 10.1007/s10840-025-02190-w. Online ahead of print.
ABSTRACT
INTRODUCTION: Cardiovascular disease is one of the leading causes of death in patients with type 2 diabetes mellitus (T2DM). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have proven to be beneficial in improving cardiovascular outcomes and reducing all-cause mortality in patients with T2DM. We aimed to investigate the effect SGLT2i use on cardiovascular outcomes inpatients with T2DM who underwent VT ablation.
METHODS: A retrospective cohort study was conducted using the TriNetX US Collaborative Network, a federated network of healthcare organizations across the United States. Adults (aged 18-80 years) with T2DM who underwent catheter ablation for ventricular tachycardia were included. Patients were stratified based on exposure to SGLT2i. Propensity score matching (1:1) was used to balance baseline characteristics. Outcomes were assessed within 3 years following the index ablation procedure. Patients with a recorded occurrence of the outcome prior to the index event were excluded from each respective outcome analysis. Kaplan-Meier analysis and log-rank tests were used for statistical comparisons with significance set at p < 0.05.
RESULTS: SGLT2 inhibitor non-users exhibited significantly higher hazard ratios (HR) for various adverse outcomes. The HR for all-cause mortality was 1.422 (95% CI: 1.279-1.581), while the HR for cardiac arrest was 1.409 (95% CI: 1.135-1.750). Additionally, the HR for post-ablation cardioversion was 1.188 (95% CI: 1.042-1.355), and the utilization of amiodarone after ablation had an HR of 1.240 (95% CI: 1.106-1.391). In contrast, the hazard ratios for redo ablation (1.039, 95% CI: 0.956-1.128), visits for ICD adjustments (0.916, 95% CI: 0.766-1.096), post-ablation use of any class of antiarrhythmics (1.139, 95% CI: 0.906-1.431), and lidocaine (0.911, 95% CI: 0.775-1.070) were less definitive.
CONCLUSION: SGLT2i non-user group was associated with significantly higher risks of several adverse outcomes following ablation, including a 42% increase in all-cause mortality and a 41% increase in cardiac arrest. Non-users also had higher rates of post-ablation cardioversion and amiodarone use. However, no significant differences were found in redo ablation, ICD adjustments, or the use of other antiarrhythmics. These findings suggest a potential protective role of SGLT2 inhibitors in selective cardiovascular outcomes. Further studies are warranted to confirm these associations and investigate the underlying mechanisms.
PMID:41351762 | DOI:10.1007/s10840-025-02190-w