SGLT2-inhibitors effects on the coronary fibrous cap thickness and major adverse cardiovascular events (MACEs) in diabetic patients with inducible myocardial ischemia and multi vessels non-obstructive coronary artery stenosis
Authors' conclusion
SGLT2-I therapy may reduce about 65% the risk to have MACEs at 1 year of follow-up, via ameliorative effects on glucose homeostasis, and by the reduction of systemic inflammatory burden, and local effects on the atherosclerotic plaque inflammation, lipids' deposit, and FCT in Mv-NOCS patients with T2DM.
Study context
- Population
- T2D patients with multivessel non-obstructive coronary stenosis (Mv-NOCS) after percutaneous coronary intervention (PCI) and optical coherence tomography (OCT) evaluation
- Participants
- 369 patients
- Exposure
- SGLT2i users vs non-SGLT2i users after PCI and OCT evaluation
- SGLT2-I usersn = 111
- Non-SGLT2-I usersn = 258reference
- Outcome
- Effects of SGLT2i on fibrous cap thickness (FCT) changes
- Follow-up
- 1 year
Main finding
As reported in the abstract
- SGLT2-I users had the highest minimum fibrous cap thickness (FCT) and lowest lipid arc degree and macrophage grade vs Non-SGLT2-I users
- SGLT2-I users vs Non-SGLT2-I users: P < 0.05
Observational data: associations, not effects.
Secondary outcomes
MACE · follow-up end
P < 0.05
- Body mass index (BMI), glycaemia, HbA1c, B-type natriuretic peptide and inflammatory cells/molecules · 6 and 12 months · lower with SGLT2-I users
- P < 0.05
Independent predictors of MACE (multivariable analysis) · 1 year
- HbA1c
- 1.930 (95% CI 1.149-2.176)
- Macrophage grade
- 1.188 (95% CI 1.073-1.315)
- SGLT2i therapy
- 0.342 (95% CI 0.180-0.651)
Original publication
SGLT2-inhibitors effects on the coronary fibrous cap thickness and MACEs in diabetic patients with inducible myocardial ischemia and multi vessels non-obstructive coronary artery stenosis. Cardiovasc Diabetol. Published 1 April 2023. doi:10.
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