The safety of sodium glucose transporter 2 inhibitors and trends in clinical and hemodynamic parameters in patients with left ventricular assist devices.

Autor: Fardman A; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Kodesh A; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.; Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA., Siegel AJ; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Segev A; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Regev E; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Maor E; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Berkovitch A; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Kuperstein R; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Morgan A; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Nahum E; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Peled Y; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Grupper A; The Cardiovascular Division, Sheba Medical Center, Tel Hashomer, Israel.; The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2024 Aug; Vol. 48 (8), pp. 902-911. Date of Electronic Publication: 2024 Feb 26.
DOI: 10.1111/aor.14733
Abstrakt: Background: The safety and impact of sodium glucose transporter 2 inhibitors (SGLT2-I) in patients with left ventricular assist devices (LVAD) are unknown.
Methods: A retrospective analysis of all consecutive patients who underwent LVAD Heart Mate 3 (HM3) implantation at a single medical center and received SGLT2-I therapy following surgery was conducted. LVAD parameters, medical therapy, laboratory tests, echocardiography, and right heart catheterization (RHC) study results were recorded and compared before and after initiation of SGLT2-I.
Results: SGLT2-I medications were initiated in 29 (21%) of 138 patients following HM3 implantation (23 (79%) received Empagliflozin and 6 (21%) Dapagliflozin). The mean age at the time of LVAD implantation was 62 ± 6.7 years, 25 (86%) were male, and 23 (79%) had diabetes mellitus. The median time from HM3 implantation to SGLT2-I initiation was 108 days, IQR (26-477). Following SGLT2-I therapy, the daily dose of furosemide decreased from 47 to 23.5 mg/day (mean difference = 23.5 mg/d, 95% CI 8.2-38.7, p = 0.004) and significant weight reduction was observed (mean difference 2.5 kg, 95% CI 0.7-4.3, p = 0.008). Moreover, a significant 5.6 mm Hg reduction in systolic pulmonary artery pressure (sPAP) was measured during RHC (95% CI 0.23-11, p = 0.042) in a subgroup of 11 (38%) patients. LVAD parameters were similar before and after SGLT2-I initiation (p > 0.2 for all). No adverse events were recorded during median follow-up of 354 days, IQR (206-786).
Conclusion: SGLT2-I treatment is safe in LVAD patients and might contribute to reduction in patients sPAP.
(© 2024 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)
Databáze: MEDLINE
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