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- Title
Treatment with SGLT2 Inhibitors in Patients with Diabetes Mellitus and Extensive Coronary Artery Disease: Mortality and Cardiovascular Outcomes.
- Authors
Chipayo-Gonzales, David; Shabbir, Asad; Vergara-Uzcategui, Carlos; Nombela-Franco, Luis; Jimenez-Quevedo, Pilar; Gonzalo, Nieves; Nuñez-Gil, Ivan; Mejia-Renteria, Hernan; Macaya-Ten, Fernando; Tirado-Conte, Gabriela; Perez-Vizcayno, Maria Jose; Fuentes, Manuel; Escaned, Javier; Fernandez-Ortiz, Antonio; Salinas, Pablo
- Abstract
Introduction: Sodium-glucose type 2 cotransporter inhibitors (SGLT2-I) have shown solid benefits in reducing cardiovascular mortality and admissions for heart failure in patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease. However, no specific studies exist in patients with high-risk coronary artery disease (CAD). Methods: Single-center, retrospective, observational study including patients with T2DM and a new diagnosis of extensive CAD (defined as left main disease or three main coronary vessel disease). Patients were recruited from 2015 until 2020, with a follow-up of at least 12 months. The primary outcome was to compare all-cause mortality in patients treated with or without SGLT2-I at discharge and adjusted by inverse probability of treatment weighting (IPTW) propensity score. Results: A total of 420 patients were included: 104 (24.7%) were treated with SGLT2-I and 316 (75.3%) were not (non-SGLT2-I group). The presentation was acute coronary syndrome in 44.3%. The mean age was 71.2 ± 10.5 years. The mean left ventricular ejection fraction was 51.5 ± 12.5%, and the mean estimated glomerular filtration rate was 73.9 ± 22 ml/min. After a mean follow-up of 3 ± 1.6 years, all-cause mortality was 16.4%, and cardiovascular mortality was 9.5%. After IPTW, the risk of all-cause death was lower in the SGLT2-I group with a hazard ratio of 0.32 (95% confidence interval 0.12–0.81), p = 0.016. With regard to secondary outcomes, patients in the SGLT2-I group were associated with less renal function deterioration but an increase in unplanned revascularizations. Conclusions: In patients with T2DM and extensive CAD, treatment with SGLT2-I after discharge was associated with a reduced risk of all-cause death.
- Subjects
HEART failure; CORONARY artery disease; CARDIOVASCULAR disease related mortality; SODIUM-glucose cotransporters; SODIUM-glucose cotransporter 2 inhibitors; DIABETES; PEOPLE with diabetes; GLUCOSE transporters
- Publication
Diabetes Therapy, 2023, Vol 14, Issue 11, p1853
- ISSN
1869-6953
- Publication type
Article
- DOI
10.1007/s13300-023-01454-w