Association of sodium-glucose cotransporter 2 inhibitors with risk of major adverse cardiovascular events in type 2 diabetes patients with acute coronary syndrome: a propensity score‑matched analysis
Main finding · MACEResult — go to the resultHazard ratio 0.659 95% CI 0.487–0.892Authors' conclusion
In T2D patients with ACS, there was a clear increasing trend in SGLT2i use. SGLT2i was associated with a significantly lower risk of MACE, driven by the decrease in the risk of CV death, and heart failure readmission. Our study confirmed real-world use and efficacy of SGLT2i in a general T2D population with ACS.
Study context
- Population
- T2D patients hospitalized for acute coronary syndrome at Civil Aviation General Hospital, January 2019 to December 2022
- Participants
- 925 patients226 matched pairs
- Exposure
- SGLT2i use vs no SGLT2i use
- Outcome
- First occurrence of MACE:
- CV death
- All cause death
- Non-fatal MI or stroke
- Coronary revascularization
- HF readmission
- Follow-up
- 1 year
Methodological detailspropensity score-matched (1:1 nearest-neighbor), single-centre
- Propensity score-matched (1:1 nearest-neighbor)
- Single-centre
Main finding
MACE
Hazard ratio
0.659
95% CI 0.487–0.892
P = 0.007
SGLT2ivs SGLT2i-free
HR 0.659 (95% CI 0.487–0.892); P = 0.007
As reported in the abstract
- Patients with major adverse cardiovascular events (MACE) in the matched cohort
- 110 (24.3%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| HF readmission · 1 year45.5% lower risk; adjusted Cox analysis · matched cohort | 0.545 (0.332–0.893) | P = 0.016 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | HR | P value |
|---|---|---|
| CV death · 1 year12.0% lower risk; adjusted Cox analysis · matched cohort | 0.880 | P = 0.033 |
Cardiovascular (CV) death · 1 year
- Cumulative incidence of CV death significantly lower with SGLT2i vs SGLT2i-free
HF readmission · 1 year
- Cumulative incidence of HF readmission significantly lower with SGLT2i vs SGLT2i-free
MACE across subgroups
- MACE preventive benefit consistent across subgroups
- P for interaction > 0.05 for all comparisons
SGLT2i use over time
- SGLT2i use in 2019
- 9.9%
- SGLT2i use in 2022
- 43.8%
Original publication
Association of sodium-glucose cotransporter 2 inhibitors with risk of major adverse cardiovascular events in type 2 diabetes patients with acute coronary syndrome: a propensity score‑matched analysis. Cardiovasc Diabetol. Published 25 March 2024. doi:10.
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