{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:07:34Z","timestamp":1788937654768,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Fabry disease (FD) is frequently complicated by renal impairment and cardiovascular events; however, evidence on sodium\u2013glucose cotransporter\u20102 inhibitors (SGLT2i) in this population is scarce. Accordingly, we assessed the association between SGLT2i exposure and cardiovascular outcomes in adults with FD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study using the TriNetX Global Collaborative Network, including adults with Fabry disease and eGFR \u2265\u200920\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      , excluding Type 1 diabetes. Patients were stratified by SGLT2 inhibitor exposure. The primary outcome was a composite of all\u2010cause death, acute myocardial infarction and acute or acute\u2010on\u2010chronic heart failure at 2 and 5\u2009years; secondary outcomes included individual components and progression to advanced kidney disease. Patients with prior non\u2010fatal outcomes were excluded from the respective analyses. Propensity score matching (1:1) and Cox proportional hazards models were used. Sensitivity analyses included alternative follow\u2010up periods, restriction to Fabry disease diagnosed from 2013 onwards and a stricter Fabry disease definition requiring \u2265\u20092 diagnoses; subgroup analyses were performed by sex and age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 14\u2009940 FD patients, 1028 (6.9%) had recorded exposure to SGLT2 inhibitors (mean age: 65.5\u2009\u00b1\u200912.0\u2009years; 53.0% male), who were older and had a higher comorbidity burden and worse baseline renal profile than non\u2010exposed patients. After PSM, 732 patients per group (exposed and non\u2010exposed patients) were available for analysis. At 2\u2009years, SGLT2i exposure was associated with a lower risk of the composite outcome (HR 0.61; 95% CI 0.38\u20130.97) and all\u2010cause death (HR 0.56; 95% CI 0.33\u20130.95). At 5\u2009years, results were consistent for the composite outcome (HR 0.56; 95% CI 0.39\u20130.79) and all\u2010cause death (HR 0.62; 95% CI 0.42\u20130.93), with reduced myocardial infarction risk (HR 0.53; 95% CI 0.30\u20130.90).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a large real\u2010world FD cohort, SGLT2i exposure was associated with lower cardiovascular risk and mortality, supporting further prospective investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71324","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:56:28Z","timestamp":1788936988000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>SGLT2<\/scp>\n                    Inhibitors and Cardiovascular Outcomes in Patients With Fabry Disease: Observations From a Federated Research Network"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2568-3721","authenticated-orcid":false,"given":"Leandra","family":"Serio","sequence":"first","affiliation":[{"name":"Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"},{"name":"Department of Life, Health and Environmental Sciences University of L'Aquila  L'Aquila Italy"},{"name":"Internal Medicine and Nephrology Division, ASL1 Avezzano\u2010Sulmona\u2010L'Aquila, San Salvatore Hospital  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Rossi","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"},{"name":"Department of Life, Health and Environmental Sciences University of L'Aquila  L'Aquila Italy"},{"name":"Internal Medicine and Nephrology Division, ASL1 Avezzano\u2010Sulmona\u2010L'Aquila, San Salvatore Hospital  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Askarinejad","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"},{"name":"Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, Policlinico di Modena  Modena Italy"},{"name":"Clinical and Experimental Medicine PhD Program University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-6234","authenticated-orcid":false,"given":"Tommaso","family":"Bucci","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"},{"name":"Internal, Vascular and Emergency Medicine\u2014Stroke Unit University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrica","family":"Marrone","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences University of L'Aquila  L'Aquila Italy"},{"name":"Internal Medicine and Nephrology Division, ASL1 Avezzano\u2010Sulmona\u2010L'Aquila, San Salvatore Hospital  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh K.","family":"Kalra","sequence":"additional","affiliation":[{"name":"Infiltrative Cardiomyopathy Program, Division of Cardiology University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Ferri","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences University of L'Aquila  L'Aquila Italy"},{"name":"Internal Medicine and Nephrology Division, ASL1 Avezzano\u2010Sulmona\u2010L'Aquila, San Salvatore Hospital  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"},{"name":"Danish Center for Health Services, Department of Clinical Medicine Aalborg University  Aalborg Denmark"},{"name":"Department of Cardiology, Lipidology and Internal Medicine With Intensive Coronary Care Unit Medical University of Bialystok  Bialystok Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22094434"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.09.027"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.31083\/j.rcm.2020.02.65"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2022.101439"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/1566523218666180404161315"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.1075639"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph16020320"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(24)00102\u20105"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12113689"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgmr.2025.101271"},{"key":"e_1_2_10_12_1","unstructured":"TriNetX L \u201cTriNetX Global Healthcare Network \u201d2026 trinetx.com."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(13)60683\u20102"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14\u20102441"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartjsupp\/suae104"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569\u2010020\u20100406\u20108"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000030310"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.70164"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13374"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611925"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812389"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.03.020"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(20)31824\u20109"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(18)32590\u2010x"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010024\u201002328\u20106"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.777083"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14145131"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023\u2010025\u201004079\u20103"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2023.107585"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023\u2010015\u20100253\u20106"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71324","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.71324","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:56:29Z","timestamp":1788936989000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/10.1111\/dom.71324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,8]]},"references-count":29,"alternative-id":["10.1111\/dom.71324"],"URL":"https:\/\/doi.org\/10.1111\/dom.71324","archive":["Portico"],"relation":{},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,8]]},"assertion":[{"value":"2026-05-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"dom.71324"}}