SGLT2 inhibitors lowered one-year mortality in adults supported with LVADs. The study in Circulation evaluated whether SGLT2 inhibitors improved clinical outcomes during the first year after LVAD implantation.

The analysis used the TriNetX Global Network to identify adults with LVADs based on diagnostic and procedural codes. Patients were stratified by exposure to canagliflozin, dapagliflozin, empagliflozin, or ertugliflozin after implantation. Propensity matching created 711 patients in each group. The primary endpoint was one-year all-cause mortality, with secondary outcomes including hospitalizations, AKI, bloodstream infections, and device complications.

Mortality was 8.0% with SGLT2 inhibitors versus 24.2%, producing a hazard ratio of 0.28. Hospitalization rates were 62.3% vs 70.7% with a hazard ratio of 0.59. AKI occurred in 43.6% vs 58.2% with a hazard ratio of 0.56. Bloodstream infections occurred in 10.7% vs 15.7% with a hazard ratio of 0.59. Device-related infections were 26.7% vs 20.3%, but results were not statistically significant.

SGLT2 inhibitors showed favorable early outcomes in LVAD recipients; however, further prospective evaluation is required.