Abstract Body (Do not enter title and authors here): Background:
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have demonstrated clinical benefits in heart failure patients, irrespective of their left ventricular ejection fraction. However, their impact on hypertrophic cardiomyopathy (HCM) remains uncertain.

Research Questions:
We aimed to investigate the relationship between SGLT2i usage and clinical outcomes among real-world HCM patients.

Methods:
This study involved patients with HCM, utilizing data from the Korean National Health Insurance Service (2018-2022). After propensity matching, we compared 2,084 HCM patients who received SGLT2i with an equal number who did not. The primary outcome assessed was a composite of all-cause death and hospitalization due to heart failure.

Results:
The use of SGLT2i significantly decreased the risk of the primary outcome (hazard ratio [HR] 0.762, 95% confidence interval [CI] 0.676-0.860, p < 0.001, Figure 1). Specifically, SGLT2i use was associated with reduced all-cause mortality (HR 0.491, 95% CI 0.404-0.596, p < 0.001) and fewer hospitalizations due to heart failure (HR 0.865, 95% CI 0.758-0.987, p =0.031). Additionally, SGLT2i use was linked to a decreased incidence of sudden cardiac death (HR 0.629, 95% CI 0.416-0.951, p = 0.028).

Conclusion:
The utilization of SGLT2i was correlated with a decreased risk of all-cause mortality and hospitalization due to heart failure among HCM patients in real-world settings.