Sodium-Glucose Cotransporter 2 Inhibitors Reduce the Risk of Major Heart Events in Type 2 Diabetes Patients With Acute Coronary Syndrome

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) use is linked with a significantly lower risk of major adverse cardiovascular events (MACE) in type 2 diabetes (T2D) patients with acute coronary syndrome (ACS), according to a study published in Cardiovascular Diabetology. 

Researchers assessed 925 T2D patients hospitalized for ACS from January 2019 to December 2022. The population of interest was stratified based on SGLT2i use or not. A 1:1 nearest-neighbor propensity score-matched (PSM) was performed to adjust for the confounding factors and facilitate the robust comparisons between groups, the researchers noted. The primary outcome was defined as the first occurrence of MACE with 1 year follow-up, which consisted of CV death, all cause death, non-fatal myocardial infarction or stroke, coronary revascularization or heart failure readmission.

Findings showed that MACE, CV death, and heart failure readmission were notably lower in the SGLT2i group compared with the SGLT2i-free group. Additionally, the researchers noted that adjusted Cox analyses demonstrated that SGLT2i was associated with a 34.1% lower risk of MACE (HR 0.659, 95% CI 0.487-0.892, P = 0.007), which was primarily driven by a decrease in the risk of CV death by 12.0% (HR 0.880, 95% CI 0.7830.990, P = 0.033), and heart failure readmission by 45.5% (HR 0.545, 95% CI 0.332-0.893, P = 0.016).

“In T2D patients with ACS, there was a clear increasing trend in SGLT2i use. SGLT2i was associated with a significantly lower risk of MACE, driven by the decrease in the risk of CV death, and heart failure readmission,” the researchers concluded. Overall, they stated that their analysis “confirmed real-world use and efficacy of SGLT2i in a general T2D population with ACS.”