The safety of sodium glucose transporter 2 inhibitors and trends in clinical and hemodynamic parameters in patients with left ventricular assist devices
© 2024 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Artificial organs - (2024) vom: 26. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fardman, Alexander [VerfasserIn] |
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| Links: |
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| Themen: |
Diuretics |
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| Anmerkungen: |
Date Revised 27.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1111/aor.14733 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368998304 |
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| 245 | 1 | 4 | |a The safety of sodium glucose transporter 2 inhibitors and trends in clinical and hemodynamic parameters in patients with left ventricular assist devices |
| 264 | 1 | |c 2024 | |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND: The safety and impact of sodium glucose transporter 2 inhibitors (SGLT2-I) in patients with left ventricular assist devices (LVAD) are unknown | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a CONCLUSION: SGLT2-I treatment is safe in LVAD patients and might contribute to reduction in patients sPAP | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a LVAD | |
| 650 | 4 | |a SGLT2-I | |
| 650 | 4 | |a diuretics | |
| 650 | 4 | |a pulmonary artery pressure | |
| 650 | 4 | |a safety | |
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| 700 | 1 | |a Siegel, Allison Joyce |e verfasserin |4 aut | |
| 700 | 1 | |a Segev, Amitai |e verfasserin |4 aut | |
| 700 | 1 | |a Regev, Ehud |e verfasserin |4 aut | |
| 700 | 1 | |a Maor, Elad |e verfasserin |4 aut | |
| 700 | 1 | |a Berkovitch, Anat |e verfasserin |4 aut | |
| 700 | 1 | |a Kuperstein, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Morgan, Avi |e verfasserin |4 aut | |
| 700 | 1 | |a Nahum, Eyal |e verfasserin |4 aut | |
| 700 | 1 | |a Peled, Yael |e verfasserin |4 aut | |
| 700 | 1 | |a Grupper, Avishay |e verfasserin |4 aut | |
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