SGLT2 inhibitor therapy and clinical outcomes in HIV-related cardiomyopathy

HIV cardiomyopathy (HIV-CM) is associated with significant morbidity and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have benefits in heart failure (HF), but their role in the specialized population of HIV-CM is poorly understood. Patients in the TriNetX Network with HIV-CM and SGLT2i therapy were compared to a propensity matched control group of patients with HIV-CM without SGLT2i use. The primary endpoint was all-cause mortality, secondary endpoints included all-cause hospitalizations, acute HF, stroke, acute myocardial infarction (MI), cardiac arrest, atrial fibrillation and ventricular tachycardia. In the total of 2606 included patients, SGLT2i therapy was associated with significant reduction in all-cause mortality (HR 0.475, 95%CI 0.337–0.671), all-cause hospitalization (HR 0.725, 95%CI 0.646–0.814). No significant differences were observed in the individual outcomes of acute HF, MI, stroke, or cardiac arrest. SGLT2i use was associated with significant reductions in all-cause mortality and hospitalizations in patients with HIV-CM. • Data was independently retrieved from the TriNetX Research Network, a global research database of de-identified electronic patient records from over 100 healthcare organizations, with the majority in the United States. • This study was retrospective in nature and did not involve active patient intervention. Approval from the Institutional Review Board (IRB)was not needed given the de-identified and aggregated nature of the database (IRB Protocol# 24-013396). • It adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cohort studies.