Ansari Huzaifa Ul Haq, Samad Muhammad Ammar, Mahboob Eman, Zulfiqar Eeshal, Qazi Shurjeel Uddin, Ahsan Areeba, Ahmed Mushood, Ahmed Faizan, Ahmed Raheel, Ali Shafaqat, Alam Mahboob, Rana Jamal S, Fonarow Gregg C
Dow University of Health Sciences, Karachi, Pakistan.
Foundation University Medical College, Islamabad, Pakistan.
Am J Prev Cardiol. 2024 Dec 31;21:100927. doi: 10.1016/j.ajpc.2024.100927. eCollection 2025 Mar.
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown benefits in improving cardiovascular (CV) outcomes in patients with heart failure (HF) and may mitigate symptom progression in myocardial infarction (MI). However, their effectiveness in patients with type 2 diabetes and MI undergoing percutaneous coronary intervention (PCI) is unclear.
To identify eligible studies, a comprehensive search of electronic databases, PubMed, Cochrane Library, Scopus and Embase, was conducted from inception until May 2024. Results were presented as risk ratios (RR) and their corresponding 95 % confidence intervals (CIs).
Our analysis included 8 observational studies comprising 24,229 patients. The results indicated that SGLT2i with PCI was associated with a significantly reduced risk of all-cause death (RR=0.61; 95 % CI=0.54 to 0.68), CV death (RR=0.46; 95 % CI=0.22 to 0.94), major adverse cardiovascular events (RR=0.80;95 % CI: 0.66 to 0.96), HF-related hospitalizations (RR=0.63; 95 % CI=0.44 to 0.90), stroke (RR=0.77; 95 % CI: 0.62 to 0.96) and acute kidney injury (RR=0.46; 95 % CI: 0.25 to 0.84) compared to PCI without SGLT2i use. However, the risk of revascularization remained comparable between the groups.
Our study demonstrates that SGLT2i with PCI in patients with type 2 diabetes and MI are associated with improved CV outcomes compared to PCI without SGLT2i use. Randomized controlled trials are required to confirm the improvement in outcomes with SGLT2i therapy combined with PCI in patients with MI and diabetes.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）已显示出对改善心力衰竭（HF）患者的心血管（CV）结局有益，并且可能减轻心肌梗死（MI）患者的症状进展。然而，它们在接受经皮冠状动脉介入治疗（PCI）的2型糖尿病合并MI患者中的有效性尚不清楚。
为了确定符合条件的研究，我们从数据库建立之初至2024年5月对电子数据库、PubMed、Cochrane图书馆、Scopus和Embase进行了全面检索。结果以风险比（RR）及其相应的95%置信区间（CI）表示。
我们的分析纳入了8项观察性研究，共24229例患者。结果表明，与未使用SGLT2i的PCI相比，使用SGLT2i进行PCI可显著降低全因死亡风险（RR=0.61；95%CI=0.54至0.68）、心血管死亡风险（RR=0.46；95%CI=0.22至0.94）、主要不良心血管事件风险（RR=0.80；95%CI：0.66至0.96）、心力衰竭相关住院风险（RR=0.63；95%CI=0.44至0.90）、中风风险（RR=0.77；95%CI：0.62至0.96）和急性肾损伤风险（RR=0.46；95%CI：0.25至0.84）。然而，两组之间的血运重建风险仍然相当。
我们的研究表明，与未使用SGLT2i的PCI相比，2型糖尿病合并MI患者使用SGLT2i进行PCI与改善心血管结局相关。需要进行随机对照试验来证实SGLT2i治疗联合PCI对MI和糖尿病患者结局的改善作用。
