Maqola

Preoperative SGLT2 Inhibitor Use and Outcomes After Major Cardiac Procedures: A Propensity Score-Matched Analysis of the TriNetX Network

Mirza Muhammad Hadeed KhawarServices Institute of Medical Sciences, Lahore 54000, PakistanFaizan AhmedHackensack Meridian Health, Jersey Shore University Medical Center, Neptune, NJ 07753, USAMohab ElnasharDepartment of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USACheryl Vanessa LewisDepartment of Medicine, Tbilisi State Medical University, Tbilisi 0186, GeorgiaMinahil ShahidDepartment of Medicine, Shalamar Medical and Dental College, Lahore 54840, PakistanAli Asgher ShujaDepartment of Medicine, Salim Habib University, Karachi 74900, PakistanFatima AfzalDepartment of Medicine, Khalida Memorial Institute of Allied & Medical Sciences, Sialkot 51310, PakistanNaheed SajjadDepartment of Medicine, Sardar Bahadur Khan Women University, Quetta 87300, PakistanMuhammad Amir KhanDepartment of Medicine, Fergana Medical Institute of Public Health, Fergana 150100, UzbekistanMeeran AttaServices Institute of Medical Sciences, Lahore 54000, PakistanUmair ArshadServices Institute of Medical Sciences, Lahore 54000, PakistanMuneeb KhawarDepartment of Medicine, King Edward Medical University, Lahore 54000, PakistanNazila DalirSchool of Medicine, St. George’s University, St. George’s 00000, GrenadaHaris Bin TahirLahore General Hospital, Lahore 54000, Pakistan

2026en

ABI

Annotatsiya

Background/Objectives: Sodium–glucose cotransporter-2 (SGLT2) inhibitors improve cardiorenal outcomes in patients with diabetes, heart failure, and chronic kidney disease. Their association with perioperative outcomes after major cardiac procedures remains uncertain. Methods: In this retrospective cohort study using the TriNetX U.S. Collaborative Network, adults (≥18 years) undergoing cardiac procedures were identified. Patients with documented SGLT2 inhibitor use within 1 year before the index procedure were compared with non-users. Risk ratios (RR), risk differences, Kaplan–Meier survival curves, and Cox models were used for analysis. Results: Of 150,724 patients identified, 7526 propensity score-matched pairs were analyzed. The matched cohorts had a mean age of 65.8 ± 10.6 years and were predominantly male (70.5% male, 29.5% female). Preoperative SGLT2 inhibitor use was associated with significantly lower all-cause mortality at 30 days (1.3% vs. 2.3%; RR 0.566 [95% CI 0.443–0.722], p < 0.001), 90 days (2.2% vs. 3.4%; RR 0.643, p < 0.001), and 1 year (3.8% vs. 5.8%; RR 0.657, p < 0.001). MACE rates were similar between groups at all time points. Acute kidney injury at 30 days was lower with SGLT2 inhibitors (15.4% vs. 17.7%; RR 0.870, p < 0.001), whereas hospital admission rates were higher (76.4% vs. 68.7%; RR 1.111 [95% CI 1.089–1.133], p < 0.001). These associations were consistent in diabetes-only and obesity-only subgroups and in a 30-day landmark sensitivity analysis. Conclusions: In this large, contemporary, multi-institutional propensity score-matched cohort, preoperative SGLT2 inhibitor use was associated with reduced all-cause mortality and acute kidney injury after major cardiac procedures. These real-world findings support the conduct of dedicated randomized trials evaluating perioperative SGLT2 inhibitor therapy.

Hali tarjima qilinmagan

Identifikatorlar

DOI: 10.3390/jcm15176808

Iqtiboslar va manbalar

0 ta iqtibos20 ta foydalanilgan manba