Dapagliflozin reduces risk of heart failure rehospitalization in diabetic acute myocardial infarction patients: a propensity score-matched analysis

Mao, Lipeng; Cai, Dabei; Chi, Boyu; Xiao, Tingting; Zou, Ailin; Wang, Yu; Chen, Qianwen; Gu, Qun; Wang, Qingjie; Ji, Yuan

doi:10.1007/s00228-023-03495-3

Cited by 9 publications

(5 citation statements)

References 51 publications

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“…A total of 5 eligible studies encompassing 5398 patients (1576 in the SGLT2-I group and 3822 in the non-SGLT2-I group) were included in the pooled analysis [ 17 , 18 , 19 , 20 , 21 ]. All included studies were retrospective in nature.…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 (Ref. [ 17 , 18 , 19 , 20 , 21 ]) presents a summary of the study and patient characteristics. The details of the risk of bias assessment of all eligible studies are provided in Table 2 (Ref.…”

Section: Resultsmentioning

confidence: 99%

“…The details of the risk of bias assessment of all eligible studies are provided in Table 2 (Ref. [ 17 , 18 , 19 , 20 , 21 ]).…”

Section: Resultsmentioning

confidence: 99%

“…Five articles with a total of 5398 patients (1576 in the SGLT2-I group versus 3822 in the non-SGLT2-I group) reported data on rehospitalization [ 17 , 18 , 19 , 20 , 21 ]. The pooled results showed that the rate of rehospitalization was significantly lower in the SGLT2-I group than in the non-SGLT2-I group (OR, 0.45 [95% CI, 0.26–0.76]; p = 0.003; Fig.…”

Section: Resultsmentioning

confidence: 99%

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Effect of SGLT-2 Inhibitors on Prognosis in Diabetic Patients with Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Li,

Sun

et al. 2024

Rev. Cardiovasc. Med.

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Background: The present meta-analysis aimed to examine the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on the prognosis of diabetes patients who experienced acute myocardial infarction (AMI). This investigation encompassed an array of clinical endpoints, comprising cardiovascular death, myocardial reinfarction, all-cause mortality, major adverse cardiovascular events (MACEs), and rehospitalization. Methods: The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed, Cochrane Library, Embase, and Web of Science databases were searched up to October 2023. Studies reporting clinical outcomes in diabetic patients who experienced AMI and were treated with SGLT2 inhibitors (SGLT2-I) were included. Two researchers independently selected the studies and assessed the risk of bias in the included studies using the Cochrane risk of bias tool for Risk for Bias In Non-randomized Studies-of Interventions (ROBINS-I). Results: A total of 2450 publications were initially retrieved; ultimately, five studies involving 5398 patients were included in the meta-analysis. The analysis revealed that SGLT2-I were associated with significantly lower risks of cardiovascular death (odds ratio (OR), 0.34; 95% CI, 0.14–0.82) and all-cause mortality (OR, 0.54; 95% CI, 0.38–0.76). However, SGLT2-I did not lead to a significant decrease in the rate of myocardial reinfarction (OR, 0.91; 95% CI, 0.65–1.29). SGLT2-I did lead to a significant reduction in MACEs (OR, 0.59; 95% CI, 0.35–1.0), but there was significant heterogeneity among the included studies. SGLT2-I also led to a significant reduction in rehospitalizations (OR, 0.45; 95% CI, 0.26–0.76). There was significant heterogeneity in the analysis of rehospitalization, but the effect remained significant when we excluded the main sources of heterogeneity (OR, 0.35; 95% CI, 0.24–0.52). Conclusions: The pooled analyses revealed that SGLT2-I were associated with reductions in all-cause mortality, cardiovascular death, and rehospitalization. In the future, prospective studies with larger sample sizes are needed to confirm and refine these findings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The details of the risk of bias assessment of all eligible studies are provided in Table 2 (Ref. [ 17 , 18 , 19 , 20 , 21 ]).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Effect of SGLT-2 Inhibitors on Prognosis in Diabetic Patients with Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Li,

Sun

et al. 2024

Rev. Cardiovasc. Med.

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“…Furthermore, CANVAS found that SGLT2i could lower risk of three-point MACE by 14% in 10,142 T2D patients who were at an elevated risk of CVD [ 25 ]. Recently, Mao L et al [ 26 ] reported that dapagliflozin could reduce risk of heart failure rehospitalization in diabetic acute myocardial infarction patients.…”

Section: Discussionmentioning

confidence: 99%

Association of sodium-glucose cotransporter 2 inhibitors with risk of major adverse cardiovascular events in type 2 diabetes patients with acute coronary syndrome: a propensity score‑matched analysis

Liu,

Fan,

Xiao

et al. 2024

Cardiovasc Diabetol

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Background This study aimed to investigate the association of sodium-glucose cotransporter 2 inhibitors (SGLT2i) use with cardiovascular (CV) clinical outcomes in type 2 diabetes (T2D) patients with acute coronary syndrome (ACS). Methods Data of T2D patients hospitalized for ACS at Civil Aviation General Hospital from January 2019 to December 2022 were collected. Based on SGLT2i use or not, patients were stratified as SGLT2i group and SGLT2i-free group. 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 first occurrence of major adverse cardiovascular events (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, was assessed. Kaplan–Meier analysis and Cox regressions were conducted to evaluate the prognostic significance of SGLT2i use. Subgroup analyses were performed to assess the interaction between subgroups and SGLT2i use. Results A total of 925 patients were included, and the SGLT2i use increased from 9.9% in 2019 to 43.8% in 2022. 226 pairs were finally matched using the PSM model. During 1 year follow-up period, a total of 110 patients experienced MACE in the matched cohort, with a rate of 24.3%. Survival analyses showed cumulative incidence of MACE, CV death, and heart failure readmission in the SGLT2i group were significantly lower than the SGLT2i-free group. Additionally, the 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). This MACE preventive benefit was consistent across different subgroups (P interaction > 0.05 for all comparisons). Conclusions 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. Our study confirmed real-world use and efficacy of SGLT2i in a general T2D population with ACS.

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Sodium-glucose cotransporter-2 inhibitors in acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials

Coelho Meine,

Santo,

Dolovitsch de Oliveira

et al. 2024

Heart Fail Rev

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Dapagliflozin reduces risk of heart failure rehospitalization in diabetic acute myocardial infarction patients: a propensity score-matched analysis

Cited by 9 publications

References 51 publications

Effect of SGLT-2 Inhibitors on Prognosis in Diabetic Patients with Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Effect of SGLT-2 Inhibitors on Prognosis in Diabetic Patients with Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Association of sodium-glucose cotransporter 2 inhibitors with risk of major adverse cardiovascular events in type 2 diabetes patients with acute coronary syndrome: a propensity score‑matched analysis

Sodium-glucose cotransporter-2 inhibitors in acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials

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