Longitudinal assessment of coronary plaque regression related to sodium–glucose cotransporter-2 inhibitor using coronary computed tomography angiography
Authors' conclusion
In this longitudinal CCTA cohort of T2DM patients, SGLT2i therapy markedly regressed coronary overall PV and PAV, mainly result from a significant reduction in non-calcified plaque.
Study context
- Population
- T2D patients with ≥2 coronary computed tomography angiography (CCTA) examinations (2019–2022) and non-obstructive study plaques not intervened; CCTA interval ≥12 months; no prior SGLT2i; mean age 60.5 ± 9.5 years, 69.1% male435 study plaques
- Participants
- 236 patients
- Exposure
- SGLT2i therapy vs no SGLT2i therapy
- Outcome
- Change in plaque volume (PV) and percent atheroma volume (PAV), PSM analysis
- Follow-up
- Median 14.6 (IQR 13.0, 20.0) months
Methodological detailssingle-centre, 1:1 propensity score matching, serial CCTA
- Single-centre
- 1:1 propensity score matching
- Serial CCTA
Main finding
As reported in the abstract
median 14.6 (IQR 13.0, 20.0) months
- SGLT2i vs Non-SGLT2i: P = 0.005
- SGLT2i vs Non-SGLT2i: P = 0.017
- SGLT2i vs Non-SGLT2i: P < 0.001
- SGLT2i vs Non-SGLT2i: P = 0.003
- Propensity score matched
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Reductions in overall and non-calcified PV and PAV, unmatched plaquesGreater reductions with SGLT2i | all p < 0.001 |
Plaque change after SGLT2i treatment (within SGLT2i) · median 14.6 months
- Overall, non-calcified and low-attenuation plaque volume (PV) and percent atheroma volume (PAV) decreased; calcified PV and PAV increased
- all p < 0.001
Annual changes in overall and compositional PV and PAV
- Findings remained consistent
Multivariate regression
- SGLT2i associated with attenuated progression of overall or non-calcified PV or PAV after adjustment
- all p < 0.05
Subgroups: non-calcified plaque progression
- Effect consistent across subgroups
- all p for interaction > 0.05
Original publication
Longitudinal assessment of coronary plaque regression related to sodium–glucose cotransporter-2 inhibitor using coronary computed tomography angiography. Cardiovasc Diabetol. Published 22 July 2024. doi:10.
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