Dapagliflozin Use in Children with Advanced Heart Failure Undergoing Heart Transplantation: A Matched Case-Control...

Area of Science:

• Pediatric Cardiology
• Cardiovascular Surgery
• Pharmacology

Background:

• Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, is known to cause euglycemic ketoacidosis in diabetic adults.
• The safety of preoperative dapagliflozin in non-diabetic pediatric heart transplantation (HTx) recipients is not well-established.

Purpose of the Study:

• To evaluate the safety and adverse events (AE) associated with preoperative dapagliflozin use in non-diabetic children undergoing HTx.
• To compare postoperative outcomes between pediatric HTx recipients who received dapagliflozin and those who did not.

Main Methods:

• A single-center, matched case-control study.
• Nondiabetic pediatric primary HTx recipients (<21 years) were analyzed.
• Cases (n=22) receiving dapagliflozin were matched to controls (n=44) not receiving the drug, followed through postoperative day 3.

Main Results:

• No significant differences were observed in blood glucose levels, acid-base balance, or lactate levels between groups.
• Vasopressor, inotrope, and insulin infusion requirements were similar.
• No cases of severe hypoglycemia, euglycemic ketoacidosis, or urinary tract infections were reported. No deaths occurred.

Conclusions:

• Preoperative dapagliflozin use in pediatric patients with advanced heart failure awaiting HTx is not associated with immediate postoperative adverse events.
• Hospitalization length and ICU stay were comparable between groups.
• Potential cardiovascular benefits of dapagliflozin in this population warrant further consideration.