Sodium-glucose co-transporter-2 inhibitor mediated cardio-protection: does increase of hematocrit finally matter? Sub-analysis of a prospective, observational study.

Hematocrit increase with sodium-glucose co-transporter-2 (SGLT-2) inhibitors has been proposed as a potential mechanism implicated in the well-established cardio- and reno-protection with this drug class [1]. According to a recent, large meta-analysis of randomized controlled trials in a total of 14,478 participants, SGLT-2 inhibitors led to a significant increase in hematocrit by 1.32% and in hemoglobin by 0.56 g/dl [2]. Increases in erythropoiesis and red-blood cell count, along with decreases in hepcidin, ferritin and transferrin saturation levels, have been observed [3–5]. In the present sub-analysis of a real-world study performed in the context of the COVID-19 pandemic we sought to determine the effect of different SGLT-2 inhibitors on hematocrit levels and their association with established cardiovascular risk factors. This is a sub-analysis of a single-center, prospective, observational study, conducted in