Among patients with T2DM undergoing TEER, SGLT2i use was associated with significantly lower all-cause mortality and lower risk of MAKE at 1 year, despite similar rates of MACE and AKI.
SGLT2i use was associated with significantly lower all-cause mortality at 1 year compared to non-SGLT2i use in T2DM patients undergoing TEER.
SGLT2i use was associated with a significantly reduced risk of major adverse kidney events (MAKE) at 1 year.
There was no significant difference in major adverse cardiovascular events (MACE) between SGLT2i and non-SGLT2i groups at 1 year.
There was no significant difference in acute kidney injury (AKI) rates between SGLT2i and non-SGLT2i groups at 1 year.
After propensity-score matching, cohorts were well balanced across most baseline characteristics, with a residual difference in baseline renal function.
This research suggests that a class of diabetes medications called SGLT2 inhibitors (which includes drugs like empagliflozin and dapagliflozin) may provide meaningful benefits to people with type 2 diabetes who undergo a heart procedure called transcatheter edge-to-edge mitral valve repair (TEER), which is used to fix a leaky heart valve. Researchers analyzed data from a large medical database, comparing 325 patients who were taking SGLT2 inhibitors at the time of their TEER procedure to 325 similar patients who were not taking these medications. At one year after the procedure, those taking SGLT2 inhibitors were less likely to have died (15.1% vs. 20.0%) and were significantly less likely to experience serious long-term kidney complications (6.2% vs. 11.7%). Rates of a serious heart complication composite and acute kidney injury were similar between the two groups. These findings are important because patients undergoing TEER typically have severe heart disease, making them a high-risk population where additional protective effects from medications could be particularly valuable. The lower rates of severe kidney complications in the SGLT2 inhibitor group align with the already-established kidney-protective properties of these drugs seen in other studies of heart failure patients. The fact that acute kidney injury rates were similar between the groups also suggests that SGLT2 inhibitors did not increase short-term kidney risk in this setting. This research suggests that SGLT2 inhibitors may offer survival and kidney protection benefits in this specific high-risk group of patients, but the authors note that because this was a retrospective study (looking back at existing records), the findings need to be confirmed in prospective clinical trials where patients are randomly assigned to receive the medication or not. A residual imbalance in baseline kidney function between the two groups also means some caution is warranted in interpreting the kidney-related results.
Abdelnabi M, Nhat Pham H, Ibrahim R, Allam M, Pathangey G, Choon Tan M, et al.. (2026). Outcomes of SGLT2 inhibitors after transcatheter mitral valve repair in patients with type 2 diabetes mellitus.. Journal of cardiovascular medicine (Hagerstown, Md.). https://doi.org/10.2459/JCM.0000000000001936