Sodium-glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure

Alaa Rahhal, Pharmacy Department, Hamad Medical Corporation, Doha, Qatar.
Tahseen Hamamyh, Cardiology Department, Hamad Medical Corporation, Doha, Qatar.
Ammar Chapra, Cardiology Department, Hamad Medical Corporation, Doha, Qatar.
Khaled J. Zaza, Anesthesiology, Intensive Care and Perioperative Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Mostafa Najim, Rochester Regional HealthFollow
Mohammad Hemadneh, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Hazem Faraj, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Wael Kanjo, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Ahmed Yasin, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Haneen Toba, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Wafa Mohammed, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Mohammad Khair Hamad, Endocrinology Department, Hamad Medical Corporation, Doha, Qatar.
Nawras Al-Tikrety, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Mhd Baraa Habib, Cardiology Department, Hamad Medical Corporation, Doha, Qatar.
Ahmed Awaisu, Department of Clinical Pharmacy and Practice, Qatar University, Doha, Qatar.
Ahmed Mahfouz, Pharmacy Department, Hamad Medical Corporation, Doha, Qatar.
Sumaya Alyafei, Pharmacy Department, Hamad Medical Corporation, Doha, Qatar.
Abdul Rahman Arabi, Interventional Cardiology Department, Hamad Medical Corporation, Doha, Qatar.
Ashfaq Patel, Heart Failure Department, Hamad Medical Corporation, Doha, Qatar.
Mohammed Al-Hijji, Interventional Cardiology Department, Hamad Medical Corporation, Doha, Qatar.

Department

Internal Medicine

Document Type

Article

Publication Title

Frontiers in Cardiovascular Medicine

Abstract

Background: Acute coronary syndrome (ACS) remains a risk factor for heart failure (HF). Therefore, we aimed to assess the cardioprotective role of sodium-glucose cotransporter-2 (SGLT2) inhibitors post-ACS in patients with acute HF (AHF) and diabetes.

Methods: We conducted a retrospective observational cohort study employing propensity score matching. This study involved patients with diabetes admitted with ACS complicated by AHF, defined as either new clinical HF requiring diuretics during the index admission or having an ejection fraction (EF) of < 40%. The study population was divided into two groups; (1) SGLT2 inhibitor users and (2) SGLT2 inhibitor non-users. The Cox proportional hazard regression analysis was used to evaluate the outcomes.

Results: A total of 465 patients (93% male; mean age, 55 ± 10 years) were included in this study. Using a 1 : 1 propensity score matching, 78 patients were included per arm with an absolute standardized difference of < 0.1 for all baseline characteristics. The use of SGLT2 inhibitors resulted in lower composite outcomes of ACS, HF hospitalization, and all-cause mortality at 1 month and 12 months [1 month: 2.6% vs. 11.5%, HR = 0.20 (0.04-0.94), p = 0.041; 12 months: 14.1% vs. 23.1%, HR = 0.46 (0.22-0.99), p = 0.046].

Conclusion: The findings suggest that SGLT2 inhibitors may confer cardioprotective effects in ACS-induced AHF, thereby widening the spectrum for indications of SGLT2 inhibitors.

Keywords: HF hospitalization; acute coronary syndrome; cardioprotection; heart failure; sodium–glucose cotransporter-2 (SGLT-2) inhibitors.

First Page

1383669

DOI

10.3389/fcvm.2024.1383669

Volume

11

Publication Date

5-1-2024

PubMed ID

38832317

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