**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.**
Frederick M. Lang
Clinical Cardiovascular Research Laboratory for the Elderly, NewYork-Presbyterian/Columbia University Irving Medical Center
New York, NY 10032

**Main Body of the Abstract**
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce cardiovascular mortality in heart failure (HF), but few studies have assessed SGLT2i in HF secondary to transthyretin amyloid cardiomyopathy (ATTR-CM). We conducted a retrospective study to address this lack of data.
Methods: Through our institutional database, we identified 87 SGLT2i-treated patients and 95 contemporaneous untreated control patients. We matched 42 patients in each group using a propensity score based on age, NYHA class, and Columbia risk score. After matching, no significant baseline differences were observed between groups. Changes in disease markers were then compared across groups during follow-up.
Results: The mean age of the overall population was 78.6 (SD 8.5) years. 88% of patients were male, and 95% were on tafamidis or acoramidis. Median Columbia risk score was 4 (IQR 3). Compared with controls, SGLT2i treatment was associated with significantly greater reductions from baseline in loop diuretic dose, weight, uric acid, and troponin-T during follow-up (P<0.05) (Figure). SGLT2i treatment was also associated with a significantly greater reduction from baseline than controls in eGFR at 1 and 6 months (P<0.05) but not at final follow-up after 6 months. No significant between-group differences were observed in NTproBNP (P=0.424). Numerically less HF hospitalizations (0 versus 4) occurred in SGLT2i-treated patients versus controls over a median follow-up time of 5.0 and 8.6 months, respectively. Five (11.9%) patients discontinued SGLT2i, most commonly due to genitourinary symptoms.
Conclusions: SGLT2i treatment may combat diuretic resistance, decrease volume overload, and improve troponinemia in patients with ATTR-CM. Larger long-term studies are needed.



**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.**
Frederick M. Lang
Clinical Cardiovascular Research Laboratory for the Elderly, NewYork-Presbyterian/Columbia University Irving Medical Center
New York, NY 10032

**Main Body of the Abstract**
**Background:** Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce cardiovascular mortality in heart failure (HF), but few studies have assessed SGLT2i in HF secondary to transthyretin amyloid cardiomyopathy (ATTR-CM). We conducted a retrospective study to address this lack of data.
**Methods:** Through our institutional database, we identified 87 SGLT2i-treated patients and 95 contemporaneous untreated control patients. We matched 42 patients in each group using a propensity score based on age, NYHA class, and Columbia risk score. After matching, no significant baseline differences were observed between groups. Changes in disease markers were then compared across groups during follow-up.
**Results:** The mean age of the overall population was 78.6 (SD 8.5) years. 88% of patients were male, and 95% were on tafamidis or acoramidis. Median Columbia risk score was 4 (IQR 3). Compared with controls, SGLT2i treatment was associated with significantly greater reductions from baseline in loop diuretic dose, weight, uric acid, and troponin-T during follow-up (P<0.05) (Figure). SGLT2i treatment was also associated with a significantly greater reduction from baseline than controls in eGFR at 1 and 6 months (P<0.05) but not at final follow-up after 6 months. No significant between-group differences were observed in NTproBNP (P=0.424). Numerically less HF hospitalizations (0 versus 4) occurred in SGLT2i-treated patients versus controls over a median follow-up time of 5.0 and 8.6 months, respectively. Five (11.9%) patients discontinued SGLT2i, most commonly due to genitourinary symptoms.
**Conclusions:** SGLT2i treatment may combat diuretic resistance, decrease volume overload, and improve troponinemia in patients with ATTR-CM. Larger long-term studies are needed.



SGLT2 Inhibitors for Transthyretin Amyloid Cardiomyopathy: A Propensity Score-Matched Analysis PC137 (#409)

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.