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Updated: Jun 25, 2026
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
SGLT-2 Inhibitors and Outcomes After Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis
Omer Mohammed1, Kaandeeban Mohanraj2, Diya Chakraborty3
1Government Medical College, Kozhikode, India.
JACC. Advances
|June 23, 2026
Summary
Sodium glucose co-transporter 2 inhibitors (SGLT-2i) may reduce cardiovascular events and mortality in patients undergoing transcatheter aortic valve implantation (TAVI). However, evidence certainty is low, requiring further clinical trials for confirmation.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Transcatheter aortic valve implantation (TAVI) is a successful treatment for severe aortic stenosis.
- Residual risks of heart failure and post-TAVI complications remain significant concerns.
Purpose of the Study:
- To evaluate the association between sodium glucose co-transporter 2 inhibitor (SGLT-2i) use and clinical outcomes in patients undergoing TAVI.
- To synthesize evidence from randomized controlled trials (RCTs) and observational studies on SGLT-2i use post-TAVI.
Main Methods:
- Systematic literature search across major databases (PubMed, Cochrane, Google Scholar, ScienceDirect, ClinicalTrials.gov).
- Inclusion of 1 RCT and 5 cohort studies, totaling 35,075 patients.
- Pooled analysis of adjusted hazard ratios (HRs) and risk ratios (RRs); risk of bias assessment performed.
Main Results:
- SGLT-2i use was linked to a significant reduction in major adverse cardiovascular events (pooled HR: 0.65).
- Reduced risk observed for heart failure hospitalization (pooled HR: 0.58), all-cause mortality (pooled HR: 0.71), and cardiovascular death (pooled RR: 0.55).
- Evidence certainty was downgraded due to study heterogeneity, potential bias, and the predominance of observational studies.
Conclusions:
- Peri-operative SGLT-2i use shows a potential association with improved cardiovascular outcomes after TAVI.
- The current evidence is hypothesis-generating, not conclusive, due to low certainty.
- Further rigorous clinical trials are essential to establish causality and confirm these findings.
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