Cardiovasc Ther. 2026;2026(1):e8933859. doi: 10.1155/cdr/8933859.
ABSTRACT
BACKGROUND: Patients undergoing transcatheter aortic valve implantation (TAVI) remain at risk of adverse cardiovascular and renal outcomes despite procedural advancements. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular and renal benefits across various patient populations; however, their role in patients undergoing TAVI remains unclear. This study is aimed at evaluating the association between SGLT2 inhibitor use and clinical outcomes in this population.
METHODS: We conducted a systematic review and meta-analysis comparing SGLT2 inhibitors versus non-SGLT2 inhibitors or standard care in patients undergoing TAVI. Major databases were searched through March 2026, with Embase updated through June 2026. Pooled analyses were performed using random-effects models to calculate risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs).
RESULTS: Five studies involving 6111 patients (SGLT2 inhibitors: n = 2933; control: n = 3178) were included. In primary random-effects models, SGLT2 inhibitors were associated with lower all-cause mortality (RR 0.68, 95% CI 0.48-0.97, p = 0.03), heart failure (HF) hospitalization (RR 0.62, 95% CI 0.42-0.90, p = 0.01), and major adverse cardiovascular events (RR 0.68, 95% CI 0.48-0.96, p = 0.03). However, in REML/Hartung-Knapp sensitivity analyses, CIs crossed the null for all-cause mortality, HF hospitalization, MACE, and pooled hazard ratios. Mortality benefits were absent at 6 and 12 months and in the randomized trial but persisted in low left ventricular ejection fraction (RR 0.56, 95% CI 0.35-0.89, p = 0.01). No significant differences occurred in acute kidney injury, urinary tract infections, or echocardiographic parameters.
CONCLUSION: SGLT2 inhibitor use was associated with lower all-cause mortality and HF hospitalization after TAVI, but the evidence is limited by observational designs, heterogeneity, and low certainty for several outcomes. Further randomized trials are required.
PMID:42834681 | DOI:10.1155/cdr/8933859