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– A multinational electronic-health-record cohort (TriNetX) using 1:1 propensity-score matching found baseline SGLT2 inhibitor (SGLT2i) use was associated with a 22% lower hazard of sepsis-induced cardiomyopathy (SICM) within 30 days compared with DPP4 inhibitor (DPP4i) use in patients with type 2 diabetes (T2D) and infection (HR 0.78; 95% CI 0.71–0.86).
– SGLT2i exposure also associated with lower 1-year all-cause mortality (HR 0.58), hospitalization (HR 0.83), and major adverse cardiovascular events (MACEs) (HR 0.86).
– Findings persisted across subgroup and negative-control analyses, but limitations inherent to observational designs (residual confounding, exposure ascertainment, diagnostic coding for SICM) limit causal inference; randomized trials are needed before changing acute sepsis management.
