Key result
SGLT2 inhibitors linked to ~42% lower risk of new-onset heart failure after post-PCI AMI.
Why the study?
The effect of SGLT2 inhibitors on preventing new-onset heart failure in patients with preserved LVEF after PCI for acute myocardial infarction was unclear.
Does the addition of an SGLT2 inhibitor to standard therapy reduce new-onset heart failure events in patients with acute myocardial infarction and preserved LVEF following PCI?
Cohort (n=230)
No
Does the addition of an SGLT2 inhibitor to standard therapy reduce new-onset heart failure events in patients with acute myocardial infarction and preserved LVEF following PCI?
Hazard Ratio: 0.583 (95% CI 0.371–0.916)
Absolute Event Rate: 6.09% vs 15.65%
p-value: p=0.017
Adding SGLT2 inhibitors to standard post-MI therapy in patients with preserved LVEF undergoing PCI significantly reduces new-onset heart failure and mortality.
SGLT2i use was associated with lower new-onset HF risk post-AMI with preserved EF; hypothesis-generating and requires randomized confirmation before practice change.
PURPOSE: To evaluate whether SGLT2is (sodium-glucose cotransporter-2 inhibitors prevent new-onset heart failure (HF) in patients with preserved left ventricular ejection fraction (LVEF) following percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). METHODS: This retrospective cohort study enrolled AMI-PCI patients with LVEF ≥ 50% and no prior HF. Based on discharge medication, patients were assigned to a SGLT2i group (empagliflozin or dapagliflozin 10 mg once daily) or a non-SGLT2i group. After 1:1 propensity score matching (PSM), 115 matched pairs were identified. Fasting glucose, lipid profiles, estimated glomerular filtration rate (eGFR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin I (hs-cTnI), and echocardiographic values were assessed within 72 hours post-PCI. The primary outcome was the occurrence of new-onset HF events; secondary outcomes included all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events (MACE). Follow-up period was at least 18 months. RESULTS: SGLT2i significantly reduced new-onset HF events (6.09% vs. 15.65%, P=0.020), all-cause mortality (3.48% vs. 10.43%, P=0.038), cardiovascular mortality (1.74% vs. 9.57%, P=0.010), and MACE (7.83% vs. 18.26%, P=0.019). Multivariable Cox regression confirmed SGLT2i use as an independent protective factor (HR, 0.583; 95% CI, 0.371-0.916; P=0.017). CONCLUSION: Among patients with AMI undergoing PCI and preserved LVEF, SGLT2 inhibitor use was associated with a significant reduction in new-onset HF events and improved survival outcome.
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Li et al. (2026) conducted a cohort in Acute myocardial infarction with preserved ejection fraction (n=230). SGLT2 inhibitors (empagliflozin or dapagliflozin) vs. Standard guideline-directed medical therapy without SGLT2 inhibitors was evaluated on New-onset heart failure events (composite of HF hospitalization or outpatient loop diuretics initiation) (HR 0.583, 95% CI 0.371-0.916, p=0.017). Among patients with acute myocardial infarction undergoing percutaneous coronary intervention with preserved ejection fraction, use of SGLT2 inhibitors significantly reduced the risk of new-onset heart failure events (HR 0.583).
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