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Aims <p>This study aimed to assess the association between myocardial infarction (MI) size and clinical outcome with ongoing Sodium-glucose-cotransporter-2 inhibitor (SGLT2-i) use.</p> Methods and results <p>In this retrospective single-center cohort study 681 patients with MI and diabetes mellitus type 2 (T2DM) treated with percutaneous coronary intervention (PCI) between November 2015 and December 2023 were included. 105 patients received ongoing SGLT2-i therapy and 576 were taking other glucose-lowering medication at the time of admission. The primary outcome was the size of MI. MI size was determined by the peak high-sensitive troponinT (hs-TnT x ULN [upper limit of normal]) normalized on the endangered myocardial area (EMA). No significant statistical differences were observed in hs-TnT values (hsTnT x ULN: 55 [13–174] vs. 68 [22–182]; <i>p</i> = 0.36) and EMA (41 [29–59] vs. 35 [24–59] %; <i>p</i> = 0.24) between patients with and without SGLT2-i therapy. After augmented inverse-probability weighted analyses, ongoing SGLT2-i therapy was not significantly associated with a reduced MI size (difference between means hsTnT x ULN/EMA [1/%]: − 0.24 [95% confidence interval, − 2.95 to 2.48]; <i>p</i> = 0.54). Secondary outcomes were in-hospital major adverse events and length of intensive care unit (ICU) treatment. SGLT2-i use was not associated with fewer in-hospital adverse events (3.81, vs. 4.17% [95% CI, − 2.95 to 2.48], <i>p</i> = 0.94) or with fewer days on ICU (1 [1–1] vs. 1 [1–2] days, <i>p</i> = 0.78).</p> Conclusion <p>In this retrospective cohort study of T2DM patients presenting with MI, prior prescription of SGLT2-i was not associated with reduced MI size or fewer adverse events during hospitalization for MI treated with PCI.</p> Trial registration number and date <p>DRKS00032432 (Registration Date: 07 August 2023).</p>

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SGLT2-inhibition and myocardial infarction size in patients with type 2 diabetes mellitus– Insights from an acute cardiovascular care center

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月2日

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  • Istvan Bojti,
  • Felicitas Bojti,
  • Tau Hartikainen,
  • Philipp Breibart,
  • Nikolaus Löffelhardt,
  • Christian Valina,
  • Kilian Franke,
  • Klaus Kaier,
  • Dennis Wolf,
  • Dirk Westermann,
  • Christoph B. Olivier

摘要

Aims

This study aimed to assess the association between myocardial infarction (MI) size and clinical outcome with ongoing Sodium-glucose-cotransporter-2 inhibitor (SGLT2-i) use.

Methods and results

In this retrospective single-center cohort study 681 patients with MI and diabetes mellitus type 2 (T2DM) treated with percutaneous coronary intervention (PCI) between November 2015 and December 2023 were included. 105 patients received ongoing SGLT2-i therapy and 576 were taking other glucose-lowering medication at the time of admission. The primary outcome was the size of MI. MI size was determined by the peak high-sensitive troponinT (hs-TnT x ULN [upper limit of normal]) normalized on the endangered myocardial area (EMA). No significant statistical differences were observed in hs-TnT values (hsTnT x ULN: 55 [13–174] vs. 68 [22–182]; p = 0.36) and EMA (41 [29–59] vs. 35 [24–59] %; p = 0.24) between patients with and without SGLT2-i therapy. After augmented inverse-probability weighted analyses, ongoing SGLT2-i therapy was not significantly associated with a reduced MI size (difference between means hsTnT x ULN/EMA [1/%]: − 0.24 [95% confidence interval, − 2.95 to 2.48]; p = 0.54). Secondary outcomes were in-hospital major adverse events and length of intensive care unit (ICU) treatment. SGLT2-i use was not associated with fewer in-hospital adverse events (3.81, vs. 4.17% [95% CI, − 2.95 to 2.48], p = 0.94) or with fewer days on ICU (1 [1–1] vs. 1 [1–2] days, p = 0.78).

Conclusion

In this retrospective cohort study of T2DM patients presenting with MI, prior prescription of SGLT2-i was not associated with reduced MI size or fewer adverse events during hospitalization for MI treated with PCI.

Trial registration number and date

DRKS00032432 (Registration Date: 07 August 2023).