Efficacy and tolerability of sodium-glucose cotransporter-2 inhibitors in transthyretin amyloid cardiomyopathy: A systematic review and stratified meta-analysis.
Roberta Magnano, Davide Rossi, Silvio Saraullo et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy and tolerability of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). The analysis included 18 studies with over 24,000 patients. SGLT2i therapy was associated with a significant reduction in all-cause mortality (HR 0.65, 95% CI 0.56-0.76).
Key findings
- SGLT2i therapy was associated with lower all-cause mortality (HR 0.65, 95% CI 0.56-0.76).
- Composite mortality/HF-related outcomes showed a lower risk (HR 0.69, 95% CI 0.55-0.85).
- SGLT2i therapy had low rates of discontinuation (6.9%) and genitourinary events (4.7%).
- Heart failure-related events were directionally favorable but not definitive (HR 0.73, 95% CI 0.50-1.06).
Why it matters
Understanding the role of SGLT2 inhibitors in ATTR-CM is crucial as they may offer a new therapeutic option for improving patient outcomes in this challenging condition, particularly regarding mortality.
What to keep in mind
The evidence is based on non-randomized studies, which limits certainty due to potential biases and endpoint heterogeneity.