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. 2024 May 20:11:1383669.
doi: 10.3389/fcvm.2024.1383669. eCollection 2024.

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

Alaa Rahhal  1 , Tahseen Hamamyh  2 , Ammar Chapra  2 , Khaled J Zaza  3 , Mostafa Najim  4 , Mohammad Hemadneh  5 , Hazem Faraj  5 , Wael Kanjo  5 , Ahmed Yasin  5 , Haneen Toba  5 , Wafa Mohammed  5 , Mohammad Khair Hamad  6 , Nawras Al-Tikrety  5 , Mhd Baraa Habib  2 , Ahmed Awaisu  7 , Ahmed Mahfouz  1 , Sumaya Alyafei  1 , Abdul Rahman Arabi  8 , Ashfaq Patel  9 , Mohammed Al-Hijji  8   10
Affiliations

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

Alaa Rahhal et al. Front Cardiovasc Med. .

Erratum in

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.

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Conflict of interest statement

AR, TH, AC, KJZ, MH, HF, WK, AY, HT, WM, MKH, NA-T, MHB, AM, SA, ARA, AP, and MA-H are employed by Hamad Medical Corporation. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of subjects’ enrollment.
Figure 2
Figure 2
(A) Kaplan–Meier curve of the 1-month primary outcome of the use of SGLT2 inhibitors in patients with post-ischemia-induced new-onset heart failure after PS matching (n = 156). (B) Kaplan–Meier curve of the 12-month primary outcome of the use of SGLT2 inhibitors in patients with post-ischemia-induced new-onset heart failure after PS matching (n = 156).
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