Background and Importance Sodium-glucose cotransporter 2 inhibitors (SGTL2i) are widely used to manage diabetes mellitus (DM) and heart failure (HF). Recently, safety studies have been published on their use in renal recipients, however, no evidence exists in heart transplant recipients (HTR).

Aim and Objectives To evaluate safety, tolerability and effectiveness of SGTL2i in HTR.

Material and Methods Retrospective descriptive cohort study conducted in a tertiary hospital. All adults undergoing heart transplantation (HT) from January 2016 to July 2023 treated with SGLT2i were included. Demographic, clinical and pharmacological data were recorded. Outcome measures: Body Mass Index (BMI) and HbA1c evolution, number of hospitalisations in patients with HF and adverse events (AE).

Results Among 154 HTR, 28 patients were on SGLT2i, 21.4% women, 62.1 [50.9 – 63.4] years old), 9 (32.1%) with dapagliflozin and 19 (67.9%) with empagliflozin.

SGLT2i indication were: 75% DM, 21% HF and 4% DM+HF. A total of 22 (78.6%) patients were DM, 81,8% of whom were on a combined antihyperglycemic therapy. Seven (25%) patients developed DM after HT. Median time from HT to SGTL2i initiation was 20 [4–40] months.

Three patients (10.7%) reported AE while on SGLT2i: two suffered urinary tract infections and one cephalic instability. Moreover, two patients discontinued SGTL2i, one after 4 months due to intolerance and the other after 11 months because of HbA1c normalisation. At 6 months after initiation of ISGLT2, a reduction in HbA1c of 0.2 [-1,9 – 0.3] points was observed. It was also noted a reduction in BMI of 1.4 [-2,4 – 0,8] points. In patients with HF, no HF hospitalisations occurred after initiation.

Conclusion and Relevance Our results show that SGTL2i are well-tolerated in HTR. Although these data are consistent with findings in renal recipients¹, further investigation is needed.

References and/or Acknowledgements 1. Kanbay M, Demiray A, Afsar B, Karakus KE, Ortiz A, Hornum M, et al. Sodium-glucose cotransporter 2 inhibitors for diabetes mellitus control after kidney transplantation: Review of the current evidence. Nephrology (Carlton). 2021;26(12):1007–17.

Conflict of Interest No conflict of interest.