ArticleCureus2025
Association Between Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitor Use and All-Cause Mortality in Patients With Pulmonary Arterial Hypertension.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
introductionSodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce mortality in heart failure patients with reduced and preserved ejection fraction. Their potential benefits in pulmonary arterial hypertension (PAH) are unknown. This study evaluates the relationship between SGLT2i use and all-cause mortality in patients with PAH. MATERIALS AND
methodsUsing the TriNetX Research Network, we included patients diagnosed with PAH after January 1, 2013. Group A (SGLT2i group) included patients prescribed canagliflozin, dapagliflozin, empagliflozin, or ertugliflozin, and Group B (non-SGLT2i group) included patients not using these medications. Outcomes were assessed at one-, three-, and five-year intervals following the index event (PAH diagnosis and medication initiation). Propensity score matching was used to account for demographics and comorbidities. Matched cohorts included 7,998 patients in Group A and 8,006 in Group B.
resultsOver one year, mortality occurred in 614 of 7,998 patients (7.7%) in Group A, whereas Group B experienced 1,251 deaths among 8,006 patients (15.6%), yielding a risk difference of 7.9% (p < 0.0001). This mortality advantage associated with SGLT2i inhibitor use remained evident at the three-year mark, with 1,012 of 7,998 patients (12.7%) deceased in Group A compared to 1,930 of 8,006 (24.1%) in Group B, translating to an 11.5% absolute risk difference (p < 0.0001). By five years, mortality had reached 1,139 out of 7,998 patients (14.2%) in Group A and 2,190 out of 8,006 (27.4%) in Group B, with a corresponding risk difference of 13.1% (p < 0.0001).
conclusionsSGLT2i use was associated with significant and sustained mortality reduction in PAH patients. A 13% absolute risk reduction at five years highlights the potential for a transformative impact on PAH management. Randomized controlled trials are warranted to confirm these findings and guide clinical practice.
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