Key result
SGLT2 inhibitor use in patients with acute myocardial infarction was associated with a lower rate of recurrent AMI compared to non-use (aOR 0.459; 95% CI 0.367-0.551).
Why the study?
The effects of SGLT2 inhibitors on cardiovascular outcomes after acute myocardial infarction remain poorly characterized.
Do SGLT2 inhibitors reduce recurrent AMI in patients with acute myocardial infarction?
Cohort (n=89,554)
Do SGLT2 inhibitors reduce recurrent AMI in patients with acute myocardial infarction?
Odds Ratio: 0.459 (95% CI 0.367–0.551)
In a large retrospective cohort of AMI patients, SGLT2 inhibitor use was associated with significantly reduced risks of recurrent AMI, all-cause mortality, and hospitalizations.
SGLT2-Is were associated with lower post-AMI mortality and recurrent events; hypothesis-generating and requires prospective randomized confirmation.
AIMS: Sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) improve heart failure (HF) outcomes but their effects on acute myocardial infarction (AMI) remain poorly characterized. This study aimed to evaluate the 1-year cardiovascular outcomes of SGLT2-Is among patients with AMI. METHODS AND RESULTS: We conducted an observational, retrospective cohort study using TriNetX data, including patients aged ≥18 with AMI identified via ICD-10 codes regardless of left ventricular ejection fraction (LVEF), categorized by SGLT2-Is use. Propensity score matching (PSM) was performed to balance baseline demographics, comorbidities, and medication use. Adjusted odds ratios (aORs) were estimated for the primary outcome (recurrent AMI) and the secondary outcomes (acute HF hospitalizations, stroke, all-cause hospitalizations, all-cause mortality, new-onset atrial fibrillation, and cardiac arrest). After PSM, 89 554 patients were analysed (44 777 SGLT2-Is users; 44 777 non-users). The mean age was ∼68 years in both cohorts with a similarly high burden of cardiovascular comorbidities. Mean follow-up duration was 290.854 days for SGLT2-Is users and 284.465 days for non-users. SGLT2-Is use was linked to lower rates of recurrent AMI [aOR: 0.459; 95% confidence interval (CI): 0.367-0.551], all-cause hospitalizations (aOR: 0.782; 95% CI: 0.762-0.803), all-cause mortality (aOR: 0.640; 95% CI: 0.612-0.670), and cardiac arrest (aOR: 0.834; 95% CI: 0.773-0.900). No differences were observed in acute HF hospitalizations, new-onset atrial fibrillation, or stroke. CONCLUSION: SGLT2-Is are associated with improved cardiovascular outcomes in patients with AMI, including reductions in recurrent AMI, all-cause hospitalizations and mortality, and cardiac arrest. These findings emphasize the need for prospective clinical trials involving patients with AMI and other cardiovascular comorbidities, regardless of LVEF, to confirm these results.
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Mee et al. (2025) conducted a cohort in Acute myocardial infarction (AMI) (n=89,554). Sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) vs. Non-users was evaluated on Recurrent AMI (aOR 0.459, 95% CI 0.367-0.551). SGLT2 inhibitor use in patients with acute myocardial infarction was associated with a lower rate of recurrent AMI compared to non-use (aOR 0.459; 95% CI 0.367-0.551).
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