SGLT2-inhibition and myocardial infarction size in patients with type 2 diabetes mellitus– Insights from an acute cardiovascular care center

This study aimed to assess the association between myocardial infarction (MI) size and clinical outcome with ongoing Sodium-glucose-cotransporter-2 inhibitor (SGLT2-i) use. In this retrospective single-center cohort study 681 patients with MI and diabetes mellitus type 2 (T2DM) treated with percutaneous coronary intervention (PCI) between November 2015 and December 2023 were included. 105 patients received ongoing SGLT2-i therapy and 576 were taking other glucose-lowering medication at the time of admission. The primary outcome was the size of MI. MI size was determined by the peak high-sensitive troponinT (hs-TnT x ULN upper limit of normal) normalized on the endangered myocardial area (EMA). No significant statistical differences were observed in hs-TnT values (hsTnT x ULN: 55 13-174 vs. 68 22-182; p = 0.36) and EMA (41 29-59 vs. 35 24-59 %; p = 0.24) between patients with and without SGLT2-i therapy. After augmented inverse-probability weighted analyses, ongoing SGLT2-i therapy was not significantly associated with a reduced MI size (difference between means hsTnT x ULN/EMA 1/%: - 0.24 95% confidence interval, - 2.95 to 2.48; p = 0.54). Secondary outcomes were in-hospital major adverse events and length of intensive care unit (ICU) treatment. SGLT2-i use was not associated with fewer in-hospital adverse events (3.81, vs. 4.17% 95% CI, - 2.95 to 2.48, p = 0.94) or with fewer days on ICU (1 1-1 vs. 1 1-2 days, p = 0.78). In this retrospective cohort study of T2DM patients presenting with MI, prior prescription of SGLT2-i was not associated with reduced MI size or fewer adverse events during hospitalization for MI treated with PCI. DRKS00032432 (Registration Date: 07 August 2023).