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Treatment with SGLT2 Inhibitors in Patients with Diabetes Mellitus and Extensive Coronary Artery Disease: Mortality

David Chipayo-Gonzales1,2, Asad Shabbir1,2, Carlos Vergara-Uzcategui1,2

  • 1Department of Cardiology, Hospital Clínico San Carlos, Profesor Martin Lagos sn, 28040, Madrid, Spain.

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
|September 4, 2023
PubMed
Abstract

Insights

Sodium-glucose cotransporter type 2 inhibitors (SGLT2-I) reduced all-cause mortality in patients with type 2 diabetes and extensive coronary artery disease. This study highlights SGLT2-I benefits in high-risk cardiovascular patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter type 2 inhibitors (SGLT2-I) demonstrate cardiovascular benefits in type 2 diabetes mellitus (T2DM).
  • Limited data exist on SGLT2-I efficacy in high-risk coronary artery disease (CAD) patients.

Purpose of the Study:

  • To evaluate the impact of SGLT2-I on all-cause mortality in T2DM patients with extensive CAD.
  • To assess the association of SGLT2-I treatment with cardiovascular outcomes in this specific high-risk population.

Main Methods:

  • Retrospective, single-center observational study of 420 T2DM patients with extensive CAD (2015-2020).
  • Comparison of all-cause mortality between SGLT2-I treated and untreated groups, adjusted using inverse probability of treatment weighting (IPTW).
  • Follow-up duration of at least 12 months.

Main Results:

  • 104 patients (24.7%) received SGLT2-I. Mean follow-up was 3 years.
  • IPTW-adjusted analysis showed a significantly lower risk of all-cause death in the SGLT2-I group (HR 0.32, p=0.016).
  • SGLT2-I use was linked to less renal function decline but increased unplanned revascularizations.

Conclusions:

  • SGLT2-I treatment initiated post-discharge is associated with reduced all-cause mortality in T2DM patients with extensive CAD.
  • SGLT2-I may offer significant cardiovascular and renal protective benefits in this high-risk cohort.
Keywords:
All cause deathHeart failureLeft main coronary artery diseaseMultivessel coronary artery diseaseMyocardial infarctionSodium-glucose cotransporter 2 inhibitors

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