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Reduced Incidence of Aortic Dissection in Patients With Type 2 Diabetes Treated With Sodium Glucose Transporter 2

Chi-Jung Chung1,2, Hsin-Ying Lu3,4, Mu-Chi Chung5,6

  • 1Department of Public Health, College of Public Health China Medical University Taichung City Taiwan.

Journal of the American Heart Association
|June 24, 2025
PubMed
Abstract

Insights

Sodium-glucose transport protein 2 (SGLT2) inhibitors may reduce aortic dissection risk in type 2 diabetes patients. This study found SGLT2 inhibitors correlated with a lower incidence of aortic dissection compared to DPP4 inhibitors.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose transport protein 2 (SGLT2) inhibitors are widely used for type 2 diabetes (T2D).
  • SGLT2 inhibitors have demonstrated cardiovascular protective effects.
  • The impact of SGLT2 inhibitors on aortic dissection risk in T2D patients remains unexplored.

Purpose of the Study:

  • To investigate the association between SGLT2 inhibitors and the risk of aortic dissection in patients with T2D.
  • To compare the risk of aortic dissection in T2D patients treated with SGLT2 inhibitors versus dipeptidyl peptidase 4 (DPP4) inhibitors.

Main Methods:

  • Retrospective analysis of T2D patients from Taiwan National Health Institution databases (May 2016 - Dec 2021).
  • Inclusion of patients treated with SGLT2 inhibitors (n=242,563) and DPP4 inhibitors (n=376,062) to isolate glucose-lowering effects.
  • Application of inverse probability of treatment weighting and multivariate Cox models to calculate hazard ratios and 95% CIs.

Main Results:

  • Overall aortic dissection incidence was 14.83 per 100,000 patient-years for T2D-SGLT2i and 29.56 for T2D-DPP4i.
  • T2D patients on SGLT2 inhibitors showed a significantly lower risk of aortic dissection compared to those on DPP4 inhibitors.
  • Subgroup analyses confirmed reduced aortic dissection risk with SGLT2 inhibitor use in specific T2D patient groups.

Conclusions:

  • SGLT2 inhibitor use is associated with a reduced risk of aortic dissection in patients with type 2 diabetes.
  • These findings suggest a potential protective role of SGLT2 inhibitors against aortic dissection in the T2D population.
Keywords:
DPP4 inhibitorsSGLT2 inhibitorsaortic dissectioninverse probability of treatment weightingtype 2 diabetes

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