At the American College of Cardiology (ACC) 2026 in New Orleans, retrospective results were presented demonstrating the possibility of using numerous pharmacotherapies, including sodium-glucose cotransporter-2 (SGLT2) inhibitors and colchicine, for patients after the completion of a transcatheter aortic valve replacement (TAVR) procedure. These studies tracked several different patient outcomes from the TriNetX Global Collaborative Network, a multinational database of real-world procedures.
TAVR is a recently introduced procedure used to treat severe aortic valve stenosis. Previously, this would be accomplished via open heart surgery, which has significant risks for patients and a very long recovery time. Comparatively, TAVR only requires a small incision, and patients are often sent home the next day. TAVR can also be performed in patients where open-heart surgery is not an option due to frailty or other physical factors. Therefore, there has been a push among researchers for additional studies into post-operative treatment.
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In one study, 55,147 adults who had undergone a TAVR procedure between 2019 and 2025 were retrospectively analysed for several outcome measures. Primary outcomes measured included all-cause mortality. Secondary outcome measures included heart failure, stroke, myocardial infarction, and rehospitalisation.
Of the 55,147 patients, 2,478 started SGLT2 inhibitor treatment after surgery. After matching, the SGLT2 inhibitor treatment group was associated with lower all-cause mortality, heart failure, and rehospitalisation at one, three, and five years compared to TAVR patients who had not started SGLT2 inhibitor treatment. At five years post-surgery, additional reductions in stroke and myocardial infarction were also demonstrated in the SGLT2 inhibitor treatment group.
In another study, 8,502 matched patients who had undergone a TAVR procedure between 2021 and 2024 were analysed for treatment with colchicine 30 days after the procedure. Outcomes measured in this study included pacemaker implantation, ischemic stroke, heart failure, atrial fibrillation, complete atrioventricular block (AVB), prosthetic valve dysfunction, and acute kidney injury.
Patients treated with colchicine had lower risk of pacemaker implantation, complete AVB, and prosthetic valve dysfunction. However, no significant changes in risk were found in ischemic stroke, heart failure, and atrial fibrillation. Colchicine was also found to increase the risk of acute kidney injury in the same patient population.
These early results could present a strategic opportunity for SGLT2 inhibitor and colchicine manufacturers. TAVR procedure volume has increased significantly since its introduction, and adjunct therapies that can reduce the risk of negative patient outcomes post-surgery are important, especially in the current patient population for TAVR procedures, which is often elderly patients with multiple comorbidities.
Although these initial results appear promising, there has not yet been a study analysing the effects of SGLT2 inhibitors or colchicine in randomised, placebo-controlled trials to ensure confounding variables are not present. However, the initial results from these retrospective analyses will be useful in designing and planning future prospective studies. Label expansion for both classes of drug will be dependent on the results of these studies.
