Raven Lisa M, Greenfield Jerry R, Jabbour Andrew, Macdonald Peter S, Muir Christopher A
Department of Diabetes and Endocrinology, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, Australia.
Clinical Diabetes, Appetite and Metabolism Laboratory, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, Australia.
JHLT Open. 2025 Mar 22;8:100255. doi: 10.1016/j.jhlto.2025.100255. eCollection 2025 May.
Sodium glucose cotransporter 2 inhibitors (SGLT2i) are standard of care for type 2 diabetes mellitus, heart failure, and chronic kidney disease (CKD). Heart transplant (HTx) recipients are at increased risk of diabetes and CKD, and both are independently associated with increased mortality. In a retrospective analysis of 104 HTx recipients with diabetes (23 exposed to SGLT2i, 81 not exposed), SGLT2i treatment was associated with stable renal function at 3 years post-HTx, measured by estimated glomerular filtration rate change from baseline (median change of 0 ml/min/1.73 m (interquartile range [IQR] -13 to +11)), compared to a change of -15 ml/min/1.73 m (IQR -27 to +1) in patients not exposed to SGLT2i ( = 0.02). There was no significant difference in survival by SGLT2i exposure, adjusted for diabetes type and baseline creatinine (hazard ratio 0.34, confidence intervals 0.11-1.06, = 0.06). Further investigation of SGLT2i in HTx recipients, particularly focusing on renal outcomes, is required.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）是2型糖尿病、心力衰竭和慢性肾脏病（CKD）的标准治疗药物。心脏移植（HTx）受者患糖尿病和CKD的风险增加，且二者均与死亡率升高独立相关。在一项对104例患有糖尿病的HTx受者的回顾性分析中（23例使用SGLT2i，81例未使用），通过估算的肾小球滤过率相对于基线的变化来衡量（中位数变化为0 ml/min/1.73m²（四分位间距[IQR]为-13至+11）），与未使用SGLT2i的患者相比（变化为-15 ml/min/1.73m²（IQR为-27至+1）），SGLT2i治疗与HTx术后3年的肾功能稳定相关（P = 0.02）。在根据糖尿病类型和基线肌酐进行校正后，使用SGLT2i与否在生存率方面无显著差异（风险比0.34，置信区间0.11-1.06，P = 0.06）。需要对HTx受者使用SGLT2i进行进一步研究，尤其关注肾脏结局。
