DIABETES

SGLT2 inhibitors can reduce CV risk in post-MI patients with type 2 diabetes

A Swedish nationwide registry study aimed to investigate cardiovascular outcomes of SGLT2 inhibitor therapy in patients with type 2 diabetes after myocardial infarction

Max Ryan

October 2, 2024

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  • Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been shown to reduce rates of heart failure hospitalisations and cardiovascular death in patients with type 2 diabetes and prior cardiovascular disease.
     
    Researchers from the SWEDEHEART observation registry study hypothesised that SGLT2 inhibitors could provide cardiovascular benefits in the post-myocardial infarction setting.
     
    The study aimed to investigate cardiovascular outcomes of SGLT2 inhibitor therapy in patients with type 2 diabetes after myocardial infarction in a Swedish nationwide registry.
     
    The research included all patients with type 2 diabetes surviving a type 1 acute myocardial infarction from January 1, 2018 to December 31, 2021.
     
    Patients were included if they were discharged with an estimated glomerular filtration rate (eGFR) > 30 mL/min/1.73 m2 in the nationwide Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) registry.
     
    All patients discharged with or without an SGLT2 inhibitor prescription 120 days before or within three days after discharge from the cardiac care unit were identified. The primary outcome measure was a composite of death and first hospitalisation for heart failure after one year analysed using an adjusted Cox regression.
     
    A total of 11,271 patients were included. Of these, 2498 (22.2%) received SGLT2 inhibitor treatment. Patients who were prescribed SGLT2 inhibitors were younger, more often presented with a STEMI and had worse left ventricular ejection fraction at index hospitalisation. SGLT2 inhibitor use was associated with lower rates of the composite outcome (hazard ratio (HR) of 0.70 (95% confidence interval (CI) 0.59–0.82).
     
    Treatment with SGLT2 inhibitors after myocardial infarction in patients with type 2 diabetes was associated with a lower rate of cardiovascular events.
     
    The study was published in The Lancet recently.
     
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