Effect of sodium-glucose cotransporter-2 inhibitor (SGLT2-i) in patients with LVAD: a systematic review and meta-analysis

Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) have been shown to reduce risks of clinical events in patients with heart failure (HF). Nevertheless, data on the use of SGLT2-i in patients with left ventricular assist devices (LVAD) are scarce. Elfatih A Hasabo presented at a session, a study that was conducted to assess the efficacy and safety of SGLT2-i in patients with LVAD, held at the European Society of Cardiology (ESC) Congress from 30th August to 2nd September 2024, in London.

A systematic search was conducted across PubMed, Scopus, Web of Science, Embase, and Cochrane databases up to December 2023, focusing on studies and abstracts related to the use of SGLT2 inhibitors in patients with LVAD. Data on efficacy and safety were extracted, and a meta-analysis was performed using RevMan 5.4.1. The analysis included 3 studies and 8 abstracts, totaling 209 patients treated with Empagliflozin, Dapagliflozin, or Canagliflozin. SGLT2 inhibitors significantly reduced hemoglobin A1c (Mean = -0.44) and diuretic doses (Mean = -2.54) but did not significantly improve GFR, BNP, or MPAP. The pooled incidence of driveline infection was 9.33%.

SGLT2-i effectively improves HbA1c and diuretic dose in patients using LVAD. Further randomized studies with a large number of participants may be warranted.