Impact of sodium-glucose co-transporter 2 inhibitors on cardiovascular outcomes in patients with acute myocardial infarction: Systematic review and meta-analysis.

Abstract

Background: The role of sodium-glucose co-transporter inhibitors (SGLT2i) in heart failure is well-established. However, evidence supporting their use in acute myocardial infarction remains limited.

Methods: Two independent researchers conducted a comprehensive literature review on PubMed and Embase until April 2024. They identified 14 articles, consisting of randomized controlled trials and observational studies, investigating the use of SGLT2i in acute myocardial infarction. The analysis focused on cardiovascular outcomes, including all-cause mortality, cardiovascular mortality, major adverse cardiovascular events (MACE), heart failure exacerbation, strokes, and recurrence of acute coronary syndrome.

Results: Our pooled analysis of 19,319 participants revealed a significant reduction in MACE [OR 0.50, 95 % CI [0.36; 0.70], p-value = 0.0001] and hospitalization due to heart failure [OR 0.59 (0.43-0.79), P < 0.0004] in the SGLT2i group compared to the control group. In contrast, there were no statistically significant differences between the SGLT2i and control groups regarding all-cause mortality, cardiovascular mortality, recurrence of acute coronary syndrome, or new-onset arrhythmia.

Conclusions: Our study highlights that among patients with acute myocardial infarction, the use of SGLT2i reduces MACE and hospitalizations due to heart failure. However, there was no significant reduction in mortality, recurrence of acute coronary syndrome, or arrhythmia in the SGLT2i group.