Stopping or Continuing SGLT-2 Inhibitors Before Heart Surgery in Heart Failure
Compares continuing versus stopping SGLT-2 inhibitors before heart surgery in adults with heart failure.
Plain-language title generated from the registry record
Registry title: Discontinuation or Continuation of SGLT-2 Inhibitors Before Cardiac Surgery
Key facts
- Where
- Bordeaux, Montpellier Cedex 5, Toulouse, and Toulouse Cedex 3, FranceSee the 4 sites
- Phase
- Phase 4
Where in France
- Centre hospitalier Universitaire de BordeauxBordeaux, FranceNot yet recruiting
- Centre Hospitalier Universitaire De MontpellierMontpellier Cedex 5, FranceNot yet recruiting
- Centre Hospitalier Universitaire de ToulouseToulouse, FranceNot yet recruiting
- Clinique PasteurToulouse Cedex 3, FranceNot yet recruiting
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- University Hospital, Toulouse
- Trial code
- NCT07766109EU 2025-524395-30-00
- Record updated
- 5 November 2026
- Original description
SGLT-2 inhibitors are recommended treatments for managing heart failure patients. In cases of surgery, it is recommended to stop the treatment 3 days before surgery due to the risk of postoperative euglycemic diabetic ketoacidosis. However, several data suggest that it may be beneficial to maintain SGLT-2i treatment given the possibility of improving postoperative cardiovascular outcomes. Investigator team wish to conduct a randomized controlled trial to test the hypothesis that preoperative maintenance of SGLT-2i is superior to discontinuing them 3 days before surgery in improving postoperative cardiovascular outcomes.Read full original descriptionShow less
Discontinuation or Continuation of SGLT-2 Inhibitors Before Cardiac Surgery: Impact on Postoperative Cardiovascular Outcomes - DISCO Study
SGLT-2 inhibitors are recommended treatments for managing heart failure patients. In cases of surgery, it is recommended to stop the treatment 3 days before surgery due to the risk of postoperative euglycemic diabetic ketoacidosis. However, several data suggest that it may be beneficial to maintain SGLT-2i treatment given the possibility of improving postoperative cardiovascular outcomes. Investigator team wish to conduct a randomized controlled trial to test the hypothesis that preoperative maintenance of SGLT-2i is superior to discontinuing them 3 days before surgery in improving postoperative cardiovascular outcomes.
Inclusion: Adult patients scheduled to undergo cardiac surgery with cardiopulmonary bypass; patients treated with SGLT-2 inhibitors, including combined treatment with metformin, for at least 4 weeks; heart failure patients with a left ventricular ejection fraction strictly below 50%; patients enrolled in a social security scheme or equivalent; patients who have signed the informed consent form.
Exclusion: Treatment with SGLT-2 inhibitors initiated less than 4 weeks ago and other than empagliflozine or dapagliflozine; surgery scheduled within less than 3 days; surgery for active endocarditis within the last 3 months; patients with a contraindication to SGLT-2 inhibitors: hypersensitivity, type 1 diabetes mellitus, and renal impairment with an estimated glomerular filtration rate below 25 mL/min/1.73 m²; heart transplant surgery or implantation of an LVAD (left ventricular assist device); chronic kidney disease patients with a glomerular filtration rate below 25 mL/min/1.73m²; acute conditions likely to call into question the continuation of SGLT2 inhibitor therapy (alone or in combination) at the time of inclusion, including in particular: shock state or acute tissue hypoxia (episode of hyperlactatemia > 3 mmol/L within 7 days prior to inclusion); acute kidney injury within the previous 7 days (KDIGO stage ≥2); severe hepatocellular failure (factor V level < 50%); acute alcohol intoxication within the previous 7 days or active alcohol use disorder without withdrawal; heart failure patients with a preserved ejection fraction, equal to or greater than 50; patients on preoperative mechanical circulatory support; pregnant or breastfeeding women; minors or adults under legal protection (guardianship or conservatorship); patients participating in another interventional study patients who do not understand or speak French.