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Sodium-Glucose Cotransporter-2 Inhibitors Following Acute Myocardial Infarction in Patients Without Diabetes

Muhammad Ahmed1, Muhammad Hamza Shuja1, Shajia Shakil1

  • 1Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.

Clinical Medicine Insights. Cardiology
|July 19, 2026
PubMed

Insights

Sodium-glucose transporter 2 (SGLT2) inhibitors reduce heart failure hospitalizations and improve heart function in non-diabetic patients post-myocardial infarction. Further research is recommended for this patient group.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Sodium-glucose transporter 2 (SGLT2) inhibitors demonstrate cardiovascular benefits in patients with diabetes or chronic kidney disease.
  • Limited data exist on SGLT2 inhibitor efficacy and safety in non-diabetic patients without heart failure following acute myocardial infarction.

Purpose of the Study:

  • To evaluate the efficacy of SGLT2 inhibitors in non-diabetic patients without heart failure after acute myocardial infarction.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
  • Databases searched include MEDLINE, Scopus, Cochrane Library, and ClinicalTrials.gov up to August 2025.
  • Data were pooled using random-effects models, calculating risk ratios and mean differences with 95% confidence intervals.

Main Results:

  • Five RCTs with 9,135 patients were analyzed (4,581 SGLT2i, 4,554 placebo).
  • SGLT2 inhibitors significantly reduced first heart failure hospitalization (RR: 0.74, p=0.02).
  • Improvements were observed in left ventricular ejection fraction (LVEF) (MD: 2.08; p=0.002) and NT-proBNP levels (MD: 12.81; p < 0.0001).
  • No significant differences in all-cause mortality were found.

Conclusions:

  • SGLT2 inhibitors significantly decrease heart failure hospitalizations and improve LVEF in non-diabetic patients post-acute myocardial infarction.
  • These findings support further investigation into the cardiovascular benefits of SGLT2 inhibitors in this specific population.
Abstract

Keywords:
SGLT2 inhibitorscardiovascular outcomesheart failuremeta-analysismyocardial infarction

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