More than 30% of heart transplantation (HT) recipients have pre-existing diabetes mellitus (DM), which is associated with a higher risk of graft failure and death. A systematic review and meta-analysis published in Diabetes Therapy evaluated the impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors on clinical outcomes in patients with DM following HT.

The meta-analysis included data from eight studies involving 2,755 participants. Clinical outcomes included rejection after transplantation, all-cause mortality, sepsis, weight reduction, change in body mass index (BMI), serum creatinine, estimated glomerular filtration rate (eGFR), and glycated hemoglobin (HbA1c).

SGLT2 inhibitor use was associated with a statistically significant reduction in rejection after HT (RR 0.85; 95% CI, 0.78-0.93; P=0.0001). All-cause mortality was not significantly different (RR 0.64; 95% CI, 0.32-1.29; P=0.21). Sepsis rates were similar between groups (RR 1.62; 95% CI, 0.13-20.11; P=0.71). No significant differences were observed in weight reduction, BMI, change in serum creatinine level, change in eGFR, or improvement in HbA1c following HT.

SGLT2 inhibitor use was associated with lower rejection risk after HT. Its impact on mortality and other important clinical outcomes should be further assessed with additional data.