Effect of Dapagliflozin in Type II Diabetic Patients Presenting with Acute Myocardial Infarction and Stage B Heart Failure

Document Type : Original Article

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Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Patients with type II diabetes mellitus [T2DM] and acute myocardial infarction [AMI] undergoing percutaneous coronary intervention [PCI] are at increased risk of major adverse cardiovascular events [MACE]. Sodium-glucose co-transporter 2 [SGLT2] inhibitors like dapagliflozin have demonstrated cardiovascular benefits, yet their early impact post-PCI remains underexplored.
The aim of the work: This work aimed to evaluate the effect of dapagliflozin on 30-day mortality and MACE in T2DM patients with AMI undergoing PCI and classified as stage B heart failure.
Patients and Methods: This prospective comparative study enrolled 110 T2DM patients with AMI who underwent successful PCI and were classified as stage B heart failure. Patients were divided into two groups: dapagliflozin group [n=55] and control group [n=55]. Baseline demographics, comorbidities, echocardiographic parameters, angiographic findings, and 30-day post-discharge outcomes were assessed and compared.
Results: The two groups were matched in age, gender, and comorbidities [p > 0.05], except for a higher prevalence of smoking in the control group. Anterior STEMI was the most common presentation. PCI data showed similar use of single drug-eluting stents [p = 0.6] and LAD as the most affected vessel. Echocardiographic assessments revealed comparable ejection fraction and diastolic dysfunction between groups. At 30-day follow-up, no significant difference was noted in mortality [3.6% vs. 5.5%], recurrent MI [1.8% vs. 1.8%], stroke [1.8% vs. 1.8%], heart failure symptoms [7.3% vs. 14.5%], or admissions due to heart failure [3.6% vs. 7.3%]. No dapagliflozin-related adverse events were observed.
Conclusion: Although this study did not find a statistically significant reduction in early post-discharge cardiovascular events with dapagliflozin in stage B heart failure patients with type 2 diabetes and acute myocardial infarction, previous research indicates a potentially beneficial trend that may become clearer with larger cohorts and extended follow-up. The growing evidence supporting the cardio-renal benefits of SGLT2 inhibitors warrants further investigation into their early use post-AMI.

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