Impacto de los inhibidores de SGLT2 en los resultados a largo plazo en pacientes con insuficiencia cardiaca sometidos a TAVI: un análisis de emparejamiento por propensión

IF 4.2 2区医学 Q2 Medicine

Revista espanola de cardiologia Pub Date : 2026-06-01 Epub Date: 2026-02-04 DOI:10.1016/j.recesp.2025.10.014

Omar Obeidat , Ahmad Alayyat , Abdallah Naser , Fares Ghanem , Ahmad Jabri , Milos Brankovic , Tianze Jiao , Mohammed Ruzieh , Alaq Haddad , Tamas Alexy , Pedro Villablanca , Laith Alhuneafat

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引用次数: 0

Abstract

Introduction and objectives

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve outcomes in heart failure (HF), but their role in patients undergoing transcatheter aortic valve implantation (TAVI) remains unclear. A recent randomized trial (DapaTAVI) showed reduced HF hospitalizations with SGLT2i post-TAVI, but effects on mortality and broader outcomes are unknown.

Methods

Using the TriNetX Research Network, we conducted a multicenter retrospective cohort study of adults with HF who underwent TAVI between 2015 and 2025. Patients prescribed SGLT2i within 30 days of TAVI were 1:1 propensity score-matched to nonusers. The primary outcome was all-cause mortality; secondary outcomes included hospitalizations, myocardial infarction, stroke, arrhythmias, and renal events.

Results

Among 58 193 TAVI recipients, 3022 SGLT2i users were matched to 3022 nonusers. SGLT2i use was associated with significantly lower mortality at 3 months (3.5% vs 4.9%; HR, 0.71), 6 months (5.0% vs 8.1%; HR, 0.61), 12 months (7.3% vs 10.5%; HR, 0.71), and 5 years (10.7% vs 20.6%; HR, 0.59; all P < .01). SGLT2i users also had fewer hospital or emergency room visits and a lower 5-year incidence of myocardial infarction (12.0% vs 14.4%; OR, 0.81; P = .007). Stroke incidence was lower at 6 months (4.8% vs 6.1%; P = .041) but was not sustained long term. Renal and arrhythmic outcomes were similar between groups.

Conclusions

SGLT2i use in patients with HF undergoing TAVI was associated with reduced mortality and fewer adverse cardiovascular events. These findings support the integration of SGLT2i into post-TAVI management strategies.

Full English text available from:www.revespcardiol.org/en

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SGLT2抑制剂对接受TAVI治疗的心力衰竭患者长期预后的影响：一项倾向配对分析

简介和目的钠-葡萄糖共转运蛋白-2抑制剂（SGLT2i）可改善心力衰竭（HF）的预后，但其在经导管主动脉瓣植入术（TAVI）患者中的作用尚不清楚。最近的一项随机试验（DapaTAVI）显示，tavi后SGLT2i患者的HF住院率降低，但对死亡率和更广泛的结果的影响尚不清楚。方法使用TriNetX研究网络，我们对2015年至2025年间接受TAVI的成年HF患者进行了一项多中心回顾性队列研究。TAVI治疗后30天内服用SGLT2i的患者与未使用SGLT2i的患者倾向评分匹配为1:1。主要结局是全因死亡率；次要结局包括住院、心肌梗死、中风、心律失常和肾脏事件。结果在58 193例TAVI受者中，3022例SGLT2i使用者与3022例非SGLT2i使用者相匹配。SGLT2i的使用与3个月（3.5% vs 4.9%； HR, 0.71）、6个月（5.0% vs 8.1%； HR, 0.61）、12个月（7.3% vs 10.5%； HR, 0.71）和5年（10.7% vs 20.6%； HR, 0.59; P < 0.01）的死亡率显著降低相关。SGLT2i使用者也有更少的医院或急诊室就诊和更低的5年心肌梗死发生率（12.0% vs 14.4%; or, 0.81; P = .007）。6个月时卒中发生率较低（4.8% vs 6.1%; P = 0.041），但不能长期持续。两组之间肾脏和心律失常的结局相似。结论：在接受TAVI的HF患者中使用ssglt2i可降低死亡率和减少不良心血管事件。这些发现支持将SGLT2i纳入tavi后的管理策略。完整的英文文本可从：www.revespcardiol.org/en

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista espanola de cardiologia 医学-心血管系统

CiteScore

4.20

自引率

13.60%

发文量

257

审稿时长

28 days

期刊介绍： Revista Española de Cardiología, Revista bilingüe científica internacional, dedicada a las enfermedades cardiovasculares, es la publicación oficial de la Sociedad Española de Cardiología.