Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure

BackgroundAcute coronary syndrome (ACS) remains a risk factor for heart failure (HF). Therefore, we aimed to assess the cardioprotective role of sodium–glucose cotransporter-2 (SGLT2) inhibitors post-ACS in patients with acute HF (AHF) and diabetes.MethodsWe conducted a retrospective observational c...

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Main Authors: Alaa Rahhal, Tahseen Hamamyh, Ammar Chapra, Khaled J. Zaza, Mostafa Najim, Mohammad Hemadneh, Hazem Faraj, Wael Kanjo, Ahmed Yasin, Haneen Toba, Wafa Mohammed, Mohammad Khair Hamad, Nawras Al-Tikrety, Mhd Baraa Habib, Ahmed Awaisu, Ahmed Mahfouz, Sumaya Alyafei, Abdul Rahman Arabi, Ashfaq Patel, Mohammed Al-Hijji
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-05-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2024.1383669/full
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author Alaa Rahhal
Tahseen Hamamyh
Ammar Chapra
Khaled J. Zaza
Mostafa Najim
Mohammad Hemadneh
Hazem Faraj
Wael Kanjo
Ahmed Yasin
Haneen Toba
Wafa Mohammed
Mohammad Khair Hamad
Nawras Al-Tikrety
Mhd Baraa Habib
Ahmed Awaisu
Ahmed Mahfouz
Sumaya Alyafei
Abdul Rahman Arabi
Ashfaq Patel
Mohammed Al-Hijji
Mohammed Al-Hijji
author_facet Alaa Rahhal
Tahseen Hamamyh
Ammar Chapra
Khaled J. Zaza
Mostafa Najim
Mohammad Hemadneh
Hazem Faraj
Wael Kanjo
Ahmed Yasin
Haneen Toba
Wafa Mohammed
Mohammad Khair Hamad
Nawras Al-Tikrety
Mhd Baraa Habib
Ahmed Awaisu
Ahmed Mahfouz
Sumaya Alyafei
Abdul Rahman Arabi
Ashfaq Patel
Mohammed Al-Hijji
Mohammed Al-Hijji
author_sort Alaa Rahhal
collection DOAJ
description BackgroundAcute coronary syndrome (ACS) remains a risk factor for heart failure (HF). Therefore, we aimed to assess the cardioprotective role of sodium–glucose cotransporter-2 (SGLT2) inhibitors post-ACS in patients with acute HF (AHF) and diabetes.MethodsWe conducted a retrospective observational cohort study employing propensity score matching. This study involved patients with diabetes admitted with ACS complicated by AHF, defined as either new clinical HF requiring diuretics during the index admission or having an ejection fraction (EF) of <40%. The study population was divided into two groups; (1) SGLT2 inhibitor users and (2) SGLT2 inhibitor non-users. The Cox proportional hazard regression analysis was used to evaluate the outcomes.ResultsA total of 465 patients (93% male; mean age, 55 ± 10 years) were included in this study. Using a 1 : 1 propensity score matching, 78 patients were included per arm with an absolute standardized difference of <0.1 for all baseline characteristics. The use of SGLT2 inhibitors resulted in lower composite outcomes of ACS, HF hospitalization, and all-cause mortality at 1 month and 12 months [1 month: 2.6% vs. 11.5%, HR = 0.20 (0.04–0.94), p = 0.041; 12 months: 14.1% vs. 23.1%, HR = 0.46 (0.22–0.99), p = 0.046].ConclusionThe findings suggest that SGLT2 inhibitors may confer cardioprotective effects in ACS-induced AHF, thereby widening the spectrum for indications of SGLT2 inhibitors.
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spelling doaj-art-d5e4e25b24fb49138fcd8c1f0b30226b2025-08-20T03:00:30ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-05-011110.3389/fcvm.2024.13836691383669Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failureAlaa Rahhal0Tahseen Hamamyh1Ammar Chapra2Khaled J. Zaza3Mostafa Najim4Mohammad Hemadneh5Hazem Faraj6Wael Kanjo7Ahmed Yasin8Haneen Toba9Wafa Mohammed10Mohammad Khair Hamad11Nawras Al-Tikrety12Mhd Baraa Habib13Ahmed Awaisu14Ahmed Mahfouz15Sumaya Alyafei16Abdul Rahman Arabi17Ashfaq Patel18Mohammed Al-Hijji19Mohammed Al-Hijji20Pharmacy Department, Hamad Medical Corporation, Doha, QatarCardiology Department, Hamad Medical Corporation, Doha, QatarCardiology Department, Hamad Medical Corporation, Doha, QatarAnesthesiology, Intensive Care and Perioperative Medicine Department, Hamad Medical Corporation, Doha, QatarInternal Medicine Department, Rochester Regional Health, New York, NY, United StatesInternal Medicine Department, Hamad Medical Corporation, Doha, QatarInternal Medicine Department, Hamad Medical Corporation, Doha, QatarInternal Medicine Department, Hamad Medical Corporation, Doha, QatarInternal Medicine Department, Hamad Medical Corporation, Doha, QatarInternal Medicine Department, Hamad Medical Corporation, Doha, QatarInternal Medicine Department, Hamad Medical Corporation, Doha, QatarEndocrinology Department, Hamad Medical Corporation, Doha, QatarInternal Medicine Department, Hamad Medical Corporation, Doha, QatarCardiology Department, Hamad Medical Corporation, Doha, QatarDepartment of Clinical Pharmacy and Practice, Qatar University, Doha, QatarPharmacy Department, Hamad Medical Corporation, Doha, QatarPharmacy Department, Hamad Medical Corporation, Doha, QatarInterventional Cardiology Department, Hamad Medical Corporation, Doha, QatarHeart Failure Department, Hamad Medical Corporation, Doha, QatarInterventional Cardiology Department, Hamad Medical Corporation, Doha, Qatar0Department of Medicine, Weill Cornell Medicine, Doha, QatarBackgroundAcute coronary syndrome (ACS) remains a risk factor for heart failure (HF). Therefore, we aimed to assess the cardioprotective role of sodium–glucose cotransporter-2 (SGLT2) inhibitors post-ACS in patients with acute HF (AHF) and diabetes.MethodsWe conducted a retrospective observational cohort study employing propensity score matching. This study involved patients with diabetes admitted with ACS complicated by AHF, defined as either new clinical HF requiring diuretics during the index admission or having an ejection fraction (EF) of <40%. The study population was divided into two groups; (1) SGLT2 inhibitor users and (2) SGLT2 inhibitor non-users. The Cox proportional hazard regression analysis was used to evaluate the outcomes.ResultsA total of 465 patients (93% male; mean age, 55 ± 10 years) were included in this study. Using a 1 : 1 propensity score matching, 78 patients were included per arm with an absolute standardized difference of <0.1 for all baseline characteristics. The use of SGLT2 inhibitors resulted in lower composite outcomes of ACS, HF hospitalization, and all-cause mortality at 1 month and 12 months [1 month: 2.6% vs. 11.5%, HR = 0.20 (0.04–0.94), p = 0.041; 12 months: 14.1% vs. 23.1%, HR = 0.46 (0.22–0.99), p = 0.046].ConclusionThe findings suggest that SGLT2 inhibitors may confer cardioprotective effects in ACS-induced AHF, thereby widening the spectrum for indications of SGLT2 inhibitors.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1383669/fullacute coronary syndromeheart failuresodium–glucose cotransporter-2 (SGLT-2) inhibitorsHF hospitalizationcardioprotection
spellingShingle Alaa Rahhal
Tahseen Hamamyh
Ammar Chapra
Khaled J. Zaza
Mostafa Najim
Mohammad Hemadneh
Hazem Faraj
Wael Kanjo
Ahmed Yasin
Haneen Toba
Wafa Mohammed
Mohammad Khair Hamad
Nawras Al-Tikrety
Mhd Baraa Habib
Ahmed Awaisu
Ahmed Mahfouz
Sumaya Alyafei
Abdul Rahman Arabi
Ashfaq Patel
Mohammed Al-Hijji
Mohammed Al-Hijji
Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure
Frontiers in Cardiovascular Medicine
acute coronary syndrome
heart failure
sodium–glucose cotransporter-2 (SGLT-2) inhibitors
HF hospitalization
cardioprotection
title Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure
title_full Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure
title_fullStr Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure
title_full_unstemmed Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure
title_short Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure
title_sort sodium glucose cotransporter 2 inhibitors improve cardiovascular outcomes post acute coronary syndrome complicated by acute heart failure
topic acute coronary syndrome
heart failure
sodium–glucose cotransporter-2 (SGLT-2) inhibitors
HF hospitalization
cardioprotection
url https://www.frontiersin.org/articles/10.3389/fcvm.2024.1383669/full
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