A significant proportion of patients undergoing heart transplantation (HT) present with pre-existing diabetes mellitus (DM), a condition frequently associated with increased risks of graft failure and mortality. A meta-analysis published in Diabetes Therapy evaluated the association between sodium-glucose co-transporter 2 (SGLT2) inhibitor use and post-transplant outcomes in this high-risk population.

The analysis searched various online databases for publications and analyzed the data using specialized meta-analysis software. Outcomes included the rejection post-HT, mortality, sepsis, weight reduction, change in body mass index (BMI), change in serum creatinine level, glomerular filtration rate (eGFR), and improvement in glycated hemoglobin (HbA1c). The analysis included 8 studies with a total number of 2755 participants.

The analysis showed that SGLT2 inhibitor use was associated with a significantly lower risk of rejection following transplantation (risk ratio [RR]: 0.85; 95% confidence interval [CI]: 0.78-0.93; P=0.0001). However, no statistically significant differences were observed in mortality (RR: 0.64; 95% CI: 0.32-1.29; P=0.21) or sepsis (RR: 1.62; 95% CI: 0.13-20.11; P=0.71). Similarly, no meaningful changes were observed in weight, body mass index, serum creatinine, estimated glomerular filtration rate, or glycated hemoglobin levels.

These findings suggest a potential association between SGLT2 inhibitor use and reduced rejection risk, while other clinical outcomes remain unchanged in patients with DM following HT. Further studies are warranted to clarify the long-term clinical impact.