Clinical Outcomes of Sodium Glucose Cotransporter‐2 Inhibitors in Patients Undergoing Mitral Transcatheter Edge‐to‐Edge Repair

INTRODUCTION: Adverse cardiovascular outcomes remain common among patients undergoing mitral transcatheter edge-to-edge repair (M-TEER). Despite growing evidence supporting the cardiovascular benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i), large-scale clinical data evaluating their efficacy in this specific population are limited. We aimed to assess cardiovascular outcomes associated with SGLT2i use compared with standard care using a large global research network database. METHODS: A retrospective cohort study was conducted using de-identified patient data from the TriNetX Global Research Network. Adult patients (≥ 18 years) undergoing M-TEER were included and stratified into SGLT2i and usual care cohorts according to documented SGLT2i exposure before the index M-TEER procedure. Propensity score matching (PSM) was performed to balance baseline characteristics between groups. Cox proportional hazards models were used to evaluate efficacy and safety outcomes at 6 months and 1-year follow-up. RESULTS: A total of 6793 patients undergoing M-TEER were identified, of whom 2192 received SGLT2i therapy. After PSM, 1407 patients remained in each cohort. At 6 months, the primary composite outcome (stroke, all-cause mortality, and acute heart failure) showed no significant difference between groups (HR 0.90, p = 0.508). However, significant reductions were observed in all-cause mortality (HR 0.74, p = 0.012) and all-cause hospitalizations (HR 0.82, p < 0.001). At 1 year, the primary composite outcome remained nonsignificant (HR 0.87, p = 0.244), while reductions in all-cause mortality (HR 0.76, p = 0.004) and all-cause hospitalizations (HR 0.83, p < 0.001) persisted. CONCLUSION: Among patients undergoing M-TEER, baseline SGLT2i use was associated with lower all-cause mortality and hospitalization in this observational cohort.