Title : Sodium-glucose co-transporter 2 inhibitor use in patients with stress-induced cardiomyopathy: A retrospective cohort study
Abstract:
Background: Stress-induced cardiomyopathy, also known as Takotsubo syndrome (TS), presents as acute left ventricular systolic dysfunction, typically with non-obstructed coronary arteries and regional dyskinesia, and is catecholamine mediated. TS is associated with significant morbidity and mortality. To date, no studies have examined the role of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in managing TS.
Methods: This retrospective cohort study used TriNetX, an EHR-based data platform from large academic medical centers across the United States. Patients with Type 2 Diabetes Mellitus who developed TS between January 2015 and September 2024 were identified using ICD-10 codes. Patients were divided into two cohorts based on SGLT2i use and matched via propensity scores for demographics, comorbidities, and medications. The primary outcome was 3-year all-cause mortality, while secondary outcomes included the 3-year incidence of myocardial infarction, stroke, and end-stage renal disease.
Results: In a propensity score matched population, SGLT2i use was associated with a lower risk of all-cause mortality (HR 0.48, [0.41, 0.56]). No statistically significant differences were found in the secondary outcomes including myocardial infarction, stroke, or end-stage renal disease.
Conclusions: Our analysis suggests that SGLT2i use in patients with TS is associated with reduced all-cause mortality. Further prospective, randomized studies are needed to confirm these findings.
