SGLT2 inhibitors significantly improved survival and renal outcomes in transthyretin amyloid cardiomyopathy. The analysis, published in Acta Cardiologica, assessed the efficacy of SGLT2 inhibitors in individuals with ATTR-CM receiving disease-modifying therapy.

Seven observational studies including 7,283 individuals were evaluated. Outcomes included all-cause and cardiovascular mortality, major adverse cardiovascular events, hospitalisations due to heart failure, and renal function.

SGLT2 inhibitor therapy was associated with lower all-cause mortality (risk ratio 0.51; 95% CI 0.45–0.57; p < 0.00001; I² = 10%) and cardiovascular mortality (risk ratio 0.30; 95% CI 0.16–0.55; p = 0.0001; I² = 25%). Major adverse cardiovascular events declined (risk ratio 0.69; 95% CI 0.59–0.81; p < 0.00001; I² = 10%). Glomerular filtration rate increased (mean difference 3.11 mL/min/1.73 m²; 95% CI 0.52–5.71; p = 0.02; I² = 54%). Rates of heart failure hospitalisation did not differ between groups.

These findings suggest that SGLT2 inhibitors, used alongside disease-modifying agents, may improve survival and kidney function in ATTR-CM. Confirmation in randomized controlled trials is needed to define their role in clinical practice.