**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Stefano H Byer, MD; University of Iowa Hospitals and Clinics, Iowa City, IA

**Main Body of the Abstract**
Transthyretin cardiac amyloidosis (ATTR-CM) is the most common type of cardiac amyloidosis and an increasingly recognized cause of heart failure and cardiac arrythmias. Recent data suggest that sodium-glucose contransporter-2 inhibitors (SGLT2i) may attenuate development of cardiac arrythmias in selected patient populations. However, the impact of SGLT2i on the incidence of cardiac arrythmias in ATTR-CA has not been evaluated.
We used TriNetX database to identify cohorts with both wild-type and variant ATTR-CM and T2DM, and performed a propensity score matched analysis (based on age, race, sex and co-morbidities) between patients with ATTR-CA and DM on SGLT2i versus patients with ATTR-CA and DM not on SGLT2i. Outcomes over a 10-year period were analyzed.
After propensity score matching, 1,984 patients were included in each cohort. Overall mortality was significantly lower in the SGLT2i group [OR=0.476 (0.403, 0.561), p<0.0001]. The incidence of atrial fibrillation [OR= 0.679 (0.529, 0.872), p<0.0001] and ventricular tachycardia were lower in the SGLT2i group [OR = 0.649 (0.494, 0.854), p=0.0002]. We noted a reduced incidence of sudden cardiac arrest in the SGLT2i group [OR=0.705 (0.503, 0.988), p=0.042]. However, we observed no difference in cardiac device placement or need for cardiac ablation between sub-groups with specific cardiac arrythmias.
To our knowledge, this is the first report investigating the impact of SGLT2i on cardiac arrhythmias and outcomes in patients with ATTR-CA and DM. We demonstrate a significant reduction in the rates of all-cause mortality, atrial fibrillation, ventricular tachycardia, sudden cardiac arrest.



Impact of SGLT2 Inhibitors on the Incidence of Cardiac Arrythmias and Overall Outcomes in Transthyretin Cardiac Amyloidosis OC6 (#257)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.