Sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes and myocardial infarction undergoing percutaneous coronary intervention: a systematic review and meta-analysis
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown benefits in improving cardiovascular (CV) outcomes in patients with heart failure (HF) and may mitigate symptom progression in myocardial infarction (MI). However, their effectiveness in patients with type 2 diabetes and MI undergoing percutaneous coronary intervention (PCI) is unclear.
Methods
To identify eligible studies, a comprehensive search of electronic databases, PubMed, Cochrane Library, Scopus and Embase, was conducted from inception until May 2024. Results were presented as risk ratios (RR) and their corresponding 95 % confidence intervals (CIs).
Results
Our analysis included 8 observational studies comprising 24,229 patients. The results indicated that SGLT2i with PCI was associated with a significantly reduced risk of all-cause death (RR=0.61; 95 % CI=0.54 to 0.68), CV death (RR=0.46; 95 % CI=0.22 to 0.94), major adverse cardiovascular events (RR=0.80;95 % CI: 0.66 to 0.96), HF-related hospitalizations (RR=0.63; 95 % CI=0.44 to 0.90), stroke (RR=0.77; 95 % CI: 0.62 to 0.96) and acute kidney injury (RR=0.46; 95 % CI: 0.25 to 0.84) compared to PCI without SGLT2i use. However, the risk of revascularization remained comparable between the groups.
Conclusion
Our study demonstrates that SGLT2i with PCI in patients with type 2 diabetes and MI are associated with improved CV outcomes compared to PCI without SGLT2i use. Randomized controlled trials are required to confirm the improvement in outcomes with SGLT2i therapy combined with PCI in patients with MI and diabetes.
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown benefits in improving cardiovascular (CV) outcomes in patients with heart failure (HF) and may mitigate symptom progression in myocardial infarction (MI). However, their effectiveness in patients with type 2 diabetes and MI undergoing percutaneous coronary intervention (PCI) is unclear.
Methods
To identify eligible studies, a comprehensive search of electronic databases, PubMed, Cochrane Library, Scopus and Embase, was conducted from inception until May 2024. Results were presented as risk ratios (RR) and their corresponding 95 % confidence intervals (CIs).
Results
Our analysis included 8 observational studies comprising 24,229 patients. The results indicated that SGLT2i with PCI was associated with a significantly reduced risk of all-cause death (RR=0.61; 95 % CI=0.54 to 0.68), CV death (RR=0.46; 95 % CI=0.22 to 0.94), major adverse cardiovascular events (RR=0.80;95 % CI: 0.66 to 0.96), HF-related hospitalizations (RR=0.63; 95 % CI=0.44 to 0.90), stroke (RR=0.77; 95 % CI: 0.62 to 0.96) and acute kidney injury (RR=0.46; 95 % CI: 0.25 to 0.84) compared to PCI without SGLT2i use. However, the risk of revascularization remained comparable between the groups.
Conclusion
Our study demonstrates that SGLT2i with PCI in patients with type 2 diabetes and MI are associated with improved CV outcomes compared to PCI without SGLT2i use. Randomized controlled trials are required to confirm the improvement in outcomes with SGLT2i therapy combined with PCI in patients with MI and diabetes.
Date Issued
2025-03
Date Acceptance
2024-12-30
Citation
American Journal of Preventive Cardiology, 2025, 21
ISSN
2666-6677
Publisher
Elsevier BV
Journal / Book Title
American Journal of Preventive Cardiology
Volume
21
Copyright Statement
© 2024 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
https://doi.org/10.1016/j.ajpc.2024.100927
Publication Status
Published
Article Number
100927
Date Publish Online
2024-12-31