SGLT2i helps prevent cardiovascular events in diabetes patients with acute MI

Early treatment with sodium-glucose cotransporter 2 inhibitors (SGLT2i) is associated with a lower cardiovascular risk among diabetes patients with acute myocardial infarction (MI), reports a study.

A total of 36,103 patients with diabetes and acute MI were included in the analysis. Of these, 2,149 received SGLT2i and 10,804 received dipeptidyl peptidase-4 inhibitors (DPP4i).

The use of SGLT2i within 14 days after acute MI resulted in reduced cardiovascular composite risks relative to DPP4i (hazard ratio [HR], 0.89, 95 percent confidence interval [CI], 0.82‒0.96; p=0.0017).

SGLT2i, compared with DPP4i, also reduced the risks for hospitalization for heart failure (HHR; HR, 0.86, 95 percent CI, 0.79‒0.95), MI rehospitalization (HR, 0.70, 95 percent CI, 0.62‒0.80), and cardiovascular mortality (HR, 0.65, 95 percent CI, 0.54‒0.79), but not ischaemic stroke.

The findings on the robust therapeutic efficacy of SGLT2i persisted in sensitivity analysis. In subgroup analyses, chronic kidney disease, age, and percutaneous coronary intervention appear to influence the efficacy of SGLT2i.

“The cardiovascular benefits were consistent across patients without heart failure and new SGLT2i users,” the investigators said. “Exploratory analyses revealed comparable results between SGLT2i and glucagon-like peptide-1 receptor agonists.”

This study examined the cardiovascular effects of early SGLT2i initiation among diabetes patients experiencing acute MI by emulating a target trial using data from Taiwan’s Health Research Data Integration Service of the National Health Insurance Administration.

The investigators analysed cardiovascular composite outcomes, such as HHF, MI rehospitalization, ischaemic stroke, mortality, and individual outcomes. They calculated the adjusted HRs using Cox proportional hazard models.