{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T22:42:54Z","timestamp":1776465774709,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,22]],"date-time":"2025-06-22T00:00:00Z","timestamp":1750550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000654","name":"Marie Curie","doi-asserted-by":"publisher","award":["101024833"],"award-info":[{"award-number":["101024833"]}],"id":[{"id":"10.13039\/501100000654","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have shown cardiovascular benefits of SGLT2 inhibitors. The aim of this study was to evaluate the cardiovascular effects of perioperative SGLT2 inhibition in patients undergoing cardiac surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this open\u2010label pilot study, adult patients undergoing cardiac surgery were randomized to receive a daily dose of empagliflozin (10\u2009mg; oral) 3\u2009days before surgery until 2\u2009days after surgery, or standard of care. Blood pressure, heart rate, postoperative diuresis, intravenous fluid administration, fluid balance, and vasoactive support were compared between groups during the first 24 postoperative hours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 55 patients (sex: 73% male, age: 66\u2009\u00b1\u200910\u2009years, BMI: 28\u2009\u00b1\u20094\u2009kg\/m<jats:sup>2<\/jats:sup>, empagliflozin <jats:italic>n<\/jats:italic>\u2009=\u200925, control <jats:italic>n<\/jats:italic>\u2009=\u200930) were included in this study and analyzed according to the intention\u2010to\u2010treat principle. Empagliflozin was associated with increased diuresis, mean difference 549\u2009mL (95% CI 258\u2013839, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and less positive fluid balance postoperatively, mean difference \u22121217\u2009mL (95% CI \u22122373\u2013\u2009\u221261, <jats:italic>p<\/jats:italic>\u2009=\u20090.039). Empagliflozin did not increase the amount of intravenous fluid administered. In the empagliflozin group, norepinephrine was infused for 11.8\u2009\u00b1\u200911.5\u2009h compared to 19.3\u2009\u00b1\u200919.3\u2009h in the control group (<jats:italic>p<\/jats:italic>\u2009=\u20090.080). No significant between\u2010group differences were observed in postoperative blood pressure and heart rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Perioperative SGLT2 inhibition was associated with increased diuresis and lesser fluid accumulation without an increase in vasopressor requirement. These data warrant validation and further evaluation in a larger\u2010scale, double\u2010blind, placebo\u2010controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Editorial Comment<\/jats:title><jats:p>In this sub\u2010study of the randomized MERCURI\u20102 trial of perioperative empagliflozin for nondiabetics in cardiac surgery, the authors describe the hemodynamic outcomes and fluid status of the patients. The authors noted a higher urine output and a more negative fluid balance in the intervention group compared to the placebo group. An interesting observation is the trend towards lower noradrenaline usage, although this cannot be concluded with confidence based on this data. The findings support considering and further studying the use of these medications for patients with cardiovascular disease undergoing surgery.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/onderzoekmetmensen.nl\/en\/trial\/26563;%20ClinicalTrials.gov\">https:\/\/onderzoekmetmensen.nl\/en\/trial\/26563<\/jats:ext-link> Identifier: NL9561<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.70075","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T07:39:54Z","timestamp":1750664394000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cardiovascular Outcomes of Perioperative Sodium\u2010Glucose Transporter 2 Inhibition in Cardiac Surgery Patients: An Open\u2010Label Randomized Pilot Study"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8506-2609","authenticated-orcid":false,"given":"Lars I. P.","family":"Snel","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Amsterdam University Medical Center  Amsterdam the Netherlands"},{"name":"Department of Endocrinology Amsterdam University Medical Center  Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences Research Institute  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2906-2518","authenticated-orcid":false,"given":"Maartina J. P.","family":"Oosterom\u2010Eijmael","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Amsterdam University Medical Center  Amsterdam the Netherlands"},{"name":"Department of Endocrinology Amsterdam University Medical Center  Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences Research Institute  Amsterdam the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism Research Institute  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yugeesh R.","family":"Lankadeva","sequence":"additional","affiliation":[{"name":"Preclinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Critical Care, Melbourne Medical School The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Anesthesia Austin Health  Melbourne Victoria 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