A-24 | Impact of SGLT-2 Inhibitors on Mortality after Acute Myocardial Infarction in Patients with Type II Diabetes Mellitus treated with PCI

There are limited studies on whether the prior use of SGLT2i (sodium-glucose contransporter-2 inhibitor) has cardioprotective effects following acute myocardial infarct (AMI) that underwent percutaneous coronary intervention (PCI). The aim of our study is to assess the impact of prior use of SGLT2i on in-hospital mortality in diabetic patients that underwent PCI following AMI. This retrospective cohort study identified 1371 patients with T2DM being treated with an SGLT2i presenting with AMI that underwent PCI between 2020 and 2022. A total of 687 patients were identified with an SGLT2i listed as their home medication; 684 patients were identified as without SGLT2i. The primary outcome was defined as mortality after PCI. Variables that were taken into consideration were hypertension, hyperlipidemia, age, smoking status, and coronary artery disease. Binary logistic regression was used to predict the likelihood of mortality. A Firth correction was applied due to mortality being a rare event (< 5%). 124/684 patients without prior SGLT2i use expired; 10/677 patients with prior SGLT2i expired. SGLT2 inhibitor use is not significantly associated with the likelihood of mortality, when controlling for other variables (χ2 = 0.03, p = 0.866, 95% CI [0.558, 2.000]). Age is significantly associated with the likelihood of mortality such that with each additional year in age, patients are 1.067 times as likely to expire, when controlling for other variables (χ2 = 52.69, p < 0.0001, 95% CI [1.048, 1.086]). Hypertension is significantly associated with the likelihood of mortality such that patients who have hypertension are 0.441 times as likely to expire compared to those who do not have hypertension, when controlling for other variables –or, to say it another way, patients who do not have hypertension are 2.268 (1/0.441) times as likely to expire as those who do, when controlling for other variables (χ2 = 21.81, p < 0.0001, 95% [0.313,0.622]). In conclusion, the use of SGLT2i is not associated with the likelihood of in-hospital mortality when controlling for other variables. Our findings provide new insights into the cardioprotective effects of SGLT2i in the setting of AMI.