Cardiac involvement in sarcoidosis can present with reduced left ventricular ejection fraction (LVEF) and may be accompanied by arrhythmias and adverse clinical outcomes. In The American Journal of Cardiovascular Drugs, a retrospective cohort study evaluated the association between sodium-glucose cotransporter 2 (SGLT2) inhibitor use and clinical outcomes in patients with sarcoid cardiomyopathy (SCM) and reduced LVEF.

Using the TriNetX research network database, the study identified patients with established SCM and an LVEF below 50%. Patients were categorized based on the presence or absence of SGLT2 inhibitors in their medical regimen. Outcomes assessed at 12 months included all-cause mortality, all-cause hospitalization, and heart failure (HF) hospitalization. Propensity score matching yielded 636 patients with balanced baseline characteristics. The mean age was 60 ± 12 years, and 37% were female individuals.

At 12 months, SGLT2 inhibitor use was associated with lower all-cause mortality compared with nonuse (4.1% vs 8.8%; hazard ratio [HR], 0.46; p = 0.019). SGLT2 inhibitor therapy was also associated with fewer total hospitalizations (HR, 0.79; p = 0.043) and HF hospitalizations (HR, 0.67; p = 0.016). Arrhythmic events, including ventricular tachycardia, ventricular fibrillation, cardiac arrest, and second- or third-degree heart block, occurred less frequently among patients receiving SGLT2 inhibitors (HR, 0.59; p = 0.007). Improvement in LVEF was also reported in the SGLT2 inhibitor group.

These findings showed that SGLT2 inhibitor use was associated with improved clinical outcomes in SCM with reduced LVEF.