Abstract Body (Do not enter title and authors here): Background: Hypertrophic cardiomyopathy (HCM) is a common genetic cardiac disorder that can lead to progressive heart failure and sudden cardiac death. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated therapeutic benefits in both heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF), but data on their efficacy and safety in the HCM population remain limited.
Methods: We conducted a retrospective cohort study including all patients diagnosed with HCM from 2014 to the present across three tertiary referral centers. Propensity score matching was performed between patients treated with SGLT2i and those not receiving the medication clinical outcomes were assessed at a follow up of 5 years.
Results: After matching, 614 patients with HCM were included in the analysis (307 in the SGLT2i group and 307 in the control group). Treatment with SGLT2 inhibitors was associated with a 77% reduction in all-cause mortality (HR 0.23, 95% CI: 0.13–0.34, p < 0.001) and a 30% reduction in all-cause hospitalization (HR 0.70, 95% CI: 0.55–0.89, p = 0.003). No significant differences were observed between groups in the incidence of acute decompensated heart failure (7.8% vs. 3.9%, HR 1.11, 95% CI: 0.62–1.98, p = 0.70), syncope (9.4% vs. 12%, HR 0.79, 95% CI: 0.48–1.28, p = 0.30), or ventricular arrhythmias (1.9% vs. 1.6%, HR 1.19, 95% CI: 0.36–3.91, p = 0.80). Similarly, there were no significant differences in the rates of adverse events, including urinary tract infections and acute kidney injury.
Conclusion: SGLT2 inhibitor use in patients with HCM was associated with significantly reduced all-cause mortality and hospitalization, with no increase in adverse events. These findings suggest potential benefits and support further prospective evaluation in this population.