Sex-consistent outcomes in SGLT2 inhibitor-treated acute myocardial infarction patients: a real-world study

Sex-related differences in outcomes of sodium-glucose co-transporter 2 (SGLT2) inhibitors therapy in acute myocardial infarction remain inconclusive.

This real-world retrospective study compared sex disparities in primary outcomes (pro-brain natriuretic peptide levels and left ventricular ejection fraction), secondary outcomes (major adverse cardiovascular and cerebrovascular events), and additional laboratory outcomes (serum lipids, fasting glucose, glycosylated hemoglobin, serum creatinine, urea nitrogen, and estimated glomerular filtration rate) among women and men with acute myocardial infarction who were treated with SGLT2 inhibitors.

A total of 310 patients participated in the study, of whom 244 (78.7%) were men and 66 (21.3%) were women. The baseline characteristics revealed distinct clinical and demographic profiles between the sexes regarding age, type of myocardial infarction, presence of multivessel disease, incidence of new-onset heart failure, and renal function within the study population. After two years of follow-up, no significant sex differences were observed in cardiac function (assessed by pro-brain natriuretic peptide and left ventricular ejection fraction), major adverse cardiovascular and cerebrovascular events, metabolic parameters, or renal outcomes among acute myocardial infarction patients treated with SGLT2 inhibitors. Exploratory analysis revealed a higher risk of recurrent myocardial infarction and heart failure hospitalization in female versus male patients in this cohort.

Among patients with acute myocardial infarction treated with early SGLT2 inhibitor initiation, cardiorenal-metabolic and primary clinical outcomes are sex-independent, indicating no significant sex disparities in outcomes of SGLT2 inhibitor therapy.