Abstract 14450: Effects of SGLT2 Inhibitors in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are a class of drugs initially developed for the treatment of type 2 diabetes mellitus which demonstrated benefits in reducing cardiovascular complications. However, the benefits of using SGLT2i after acute myocardial infarction (AMI) still have limited evidence. Research Questions: Does the use of SGLT2i after percutaneous coronary intervention (PCI) due to AMI contribute to reducing mortality and hospitalization due heart failure (HF)? Aims: To assess the benefit of SGLT2i after AMI in patients undergoing PCI in reducing overall mortality, cardiovascular mortality and occurrence of HF. Methods: PubMed, Scopus, Cochrane Library and Web of science databases were searched for randomized controlled trials (RCTs) comparing SGLT2i with placebo after AMI in patients undergoing PCI. We computed risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). The heterogeneity was evaluated with I 2 statistics. R Software, version 4.2.1, was used for statistical analysis. The protocol was registered in PROSPERO (CRD42023424657). Results: A total of 4 RCTs with 1,311 patients, of whom 439 (33.48%) underwent SGLT2i therapy. The mean age was 60.2 (10.9) years in the SGLT2i group and 66.5 (13.8) years in the placebo group. Mean follow-up ranged from 23 to 96 weeks. In the pooled analysis, SGLT2i significantly reduced hospitalization due to HF (RR 0.39; 95% CI 0.20-0.75; p<0.01; I 2 =0%). There were no significant differences between SGLT2i and placebo regarding cardiovascular death (RR 0.52; 95% CI 0.23-1.18; p=0.12; I 2 =20%), non-cardiovascular death (RR 0.79; 95% CI 0.26-2.38; p=0.68; I 2 =0%) and all- cause death (RR 0.59; 95% CI 0.30-1.13; p=0.11; I 2 =12%). Conclusion(s): SGLT2i were associated with a reduction in hospitalization due to HF. However, no differences were found for cardiovascular, non-cardiovascular or all-cause deaths.