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Eficacia a corto plazo de los inhibidores de SGLT2 y asociación con la puntuación SYNTAX en la retinopatía de la

Qun Zhang¹, Zhenyan Wu¹, Xue Jiang¹

¹Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Frontiers in cardiovascular medicine

|December 31, 2025

Abstracto

Background:

Type 2 diabetes (T2DM) and hypertension (HTN) are key risk factors for retinopathy and often coexist with coronary heart disease (CHD). While AI-based retinal imaging predicts CHD risk, links between CHD lesion complexity and retinopathy, and potential benefits of Sodium-Glucose Cotransporter-2 (SGLT2) inhibitors on retinopathy in CHD patients with T2DM, lack sufficient evidence.

Methods:

This case-control study (Jan 2024-Mar 2025) enrolled 642 subjects from Beijing Tongren Hospital (affiliated with Capital Medical University). Retinal imaging data were analyzed. Propensity score matching (PSM) created baseline and optimized datasets. Univariate/multivariate logistic regression assessed if CHD increases retinopathy risk in patients with T2DM, HTN, or both. Pearson correlation evaluated associations between CHD lesion complexity (SYNTAX score) and retinal parameters. Stratified analysis assessed SGLT2 inhibitor effects on retinopathy in hypertensive-diabetic subgroups with/without CHD. The analysis of SGLT2 inhibitor efficacy was based on a retrospective cohort study of drug utilization rather than a prospective randomized intervention.

Results:

Within the hypertensive-diabetic cohort, CHD patients (n = 97 SGLT2i treated vs. n = 69 controls) showed SGLT2 inhibitors reduced MRV(Venular)C risk (P < 0.001, OR = 0.584) but increased AVR1.5-2.0PD risk (P = 0.003). Post-PSM, CHD + T2DM + HTN patients had decreased MRAC vs. T2DM + HTN patients (P < 0.001, OR = 0.776). SYNTAX score positively correlated with retinal vein diameter and negatively with AVR (both P < 0.05).

Conclusion:

CHD elevates retinopathy risk in patients with T2DM, HTN, or both. Coronary lesion complexity correlates with retinal microvascular changes. SGLT2 inhibitors demonstrate a potential protective effect against some aspects of retinopathy development.

Palabras clave:

puntuación SYNTAX cardiopatía coronaria retinopatía de la cardiopatía coronaria evaluación de riesgos inhibidores del cotransportador de sodio-glucosa 2

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