SGLT2 Inhibitors exhibit Potential for Slowing Aortic Stenosis Progression: Study
Researchers have found in a new study that SGLT2 inhibitors may have disease-modifying effects in nonsevere aortic stenosis (AS). After adjustments, patients taking these inhibitors had a significantly lower risk of progressing to severe aortic stenosis. This marks a potential breakthrough, as effective medical therapy for AS has remained elusive until now.
Aortic stenosis (AS) is the leading cause of valvular heart disease-related morbidity and mortality, but there are no medical treatments to slow its progression. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have pleiotropic effects which could be disease modifying in aortic stenosis. A target trial emulation comparing the effect of the initiation of SGLT2i with no SGLT2i in patients with nonsevere aortic stenosis was performed using retrospective electronic medical record data from the Yale New Haven Health System from January 2016 to September 2022. Patients with native aortic valve sclerosis or nonsevere aortic stenosis with at least 12 months of echocardiographic follow-up were included. Patients were excluded if they had an estimated glomerular filtration rate <30 mL/min/1.73 m2 or had initiated SGLT2i >1 year before the index echocardiogram. The prespecified primary outcome was progression to severe aortic stenosis. Results: 458 patients prescribed SGLT2i and 11,240 patients never prescribed SGLT2i were included. Patients were on SGLT2i for a median of 0.9 years. Patients on SGLT2i were younger and had higher rates of diabetes and chronic kidney disease. Patients on SGLT2i were more likely to have ejection fraction ≤40%. There were no differences between groups in baseline AS severity (66% sclerosis, 23% mild stenosis, and 11% moderate in overall cohort). Patients ever prescribed SGLT2i were less likely to progress to severe aortic stenosis (HR: 0.61; 95% CI: 0.39-0.94; P = 0.03) with a progressively lower risk among patients on SGLT2i for >3, 6, and 12 months (HR: 0.54, 0.48, and 0.27, respectively). This retrospective, multicenter, observational study suggests that SGLT2i may slow the progression of nonsevere aortic stenosis.
Reference:
Shah, T, Zhang, Z, Shah, H. et al. Effect of Sodium-Glucose Cotransporter-2 Inhibitors on the Progression of Aortic Stenosis. J Am Coll Cardiol Intv. null2025, 0 (0) .
https://doi.org/10.1016/j.jcin.2024.11.036
Keywords:
SGLT2 Inhibitors, exhibit, Potential, Slowing, Aortic, Stenosis, Progression, study, Shah, T, Zhang, Z, Shah, H
