{"id":"4d3b51e2e940","type":"article","url":"https://hartvaat.nl/2026/12/01/sglt2-remmers-tonen-geen-overlevingsvoordeel-bij-pulmonale-hypertensie-cohortstu/","title":"SGLT2-remmers tonen geen overlevingsvoordeel bij pulmonale hypertensie — cohortstudie","title_en":"Sodium-Glucose Cotransporter-2 Inhibitors in World Health Organization Group 1 Pulmonary Arterial Hypertension: A REVEAL Lite 2-Matched Cohort With Time-Varying Exposure Analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"Mayo Clinic proceedings. Innovations, quality & outcomes","doi":"10.1016/j.mayocpiqo.2026.100765","source_url":"https://doi.org/10.1016/j.mayocpiqo.2026.100765","authors":["Abdelrahman Hafez","Amal Youssef","Mohamed Nour","Juan M Farina","Kamal Awad","Milagros Pereyra Pietri","Isabel G Scalia","Fatmaelzahraa Abdelfattah","Mahshad Razaghi","Laurève Chollet","Sherif Ahmed","Ramzi Ibrahim","Nikita Rafie","Robert L Scott","Chadi Ayoub","Reza Arsanjani"],"significance":4,"published":"2026-11-07","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/sglt2-remmers-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/esc-richtlijn-hartfalen-2021/"],"congress":"","summary_en":"In a retrospective, single-center cohort of 366 patients with WHO group 1 pulmonary arterial hypertension (PAH), researchers evaluated the association between SGLT2 inhibitors and clinical outcomes. While fixed-exposure analysis suggested a mortality benefit (HR 0.53; p=0.018), this association disappeared in time-varying analysis (HR 0.74; p=0.57). The findings highlight the sensitivity of observational PAH data to exposure classification and underscore the need for prospective randomized trials before SGLT2 inhibitors can be considered for this population.","created":"2026-11-01T01:51:50Z","updated":"2026-11-01T01:51:50Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een retrospectief, single-center cohort van 366 patiënten met WHO-groep 1 pulmonale arteriële hypertensie (PAH) werd het effect van SGLT2-remmers onderzocht. Hoewel de vaste-expositie-analyse een lagere sterfte suggereerde (HR 0,53; p=0,018), verdween dit effect in de tijd-variabele analyse (HR 0,74; p=0,57). De bevindingen benadrukken dat observatieonderzoek naar SGLT2-remmers bij PAH gevoelig is voor methodologische keuzes en onderstrepen de noodzaak van gerandomiseerde trials voordat klinische toepassing kan worden overwogen.","abstract_original":"Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve outcomes across several cardiometabolic conditions, but their role in World Health Organization group 1 pulmonary arterial hypertension (PAH) remains uncertain. We conducted a retrospective, single-center cohort study of adults with group 1 PAH. Patients prescribed SGLT2i were compared with patients without exposure. Propensity-score matching was performed 1:2 using age, sex, baseline REVEAL Lite 2 risk category, diabetes mellitus, and statin use. The primary outcome was all-cause mortality, and the secondary outcome was major adverse cardiovascular events. Associations were evaluated using fixed-exposure and start-stop time-varying Cox models. The matched cohort included 366 patients: 122 (33%) receiving SGLT2i and 244 (67%) controls. Most patients were classified as high risk by REVEAL Lite 2 (106 SGLT2i recipients (87%) and 215 controls (88%), respectively). In the fixed-exposure analysis, SGLT2i use was associated with lower mortality (hazard ratio [HR], 0.53; 95% CI, 0.31-0.91; P=.018), without a significant difference in major adverse cardiovascular events (HR, 1.23; 95% CI, 0.93-1.63; P=.14). In the time-varying analysis, SGLT2i exposure was not significantly associated with mortality (HR, 0.74; 95% CI, 0.26-2.11; P=.57). The apparent survival association was attenuated after accounting for treatment timing, demonstrating the sensitivity of observational PAH estimates to exposure classification and supporting prospective randomized trials."}