DOI: 10.1161/circ.148.suppl_1.16587 ISSN: 0009-7322

Abstract 16587: Sodium Glucose Cotransporter-2 Inhibitors Post Acute Coronary Syndrome Induced New Heart Failure

Alaa Rahhal, Tahseen Hamamyh, Ammar Chapra, Mostafa Najim, mohammad hemadneh, Hazem Faraj, Ahmed Yasin, Haneen Toba, Wafa Mohammed, Mohammad Khair Hamad, Wael Kanjo, Nawras Al-Tikrety, Ahmed Mahfouz, Sumaya Alyafei, Mohammed Al-Hijji, Abdulrahman Arabi, Ashfaq Patel
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Patients with acute coronary syndrome (ACS) have an unmet need for further risk reduction in major adverse cardiovascular events (MACE) and heart failure (HF) development despite guideline-directed medical therapy. As sodium glucose cotransporter-2 inhibitors (SGLT2i) are cardioprotective, in this study, we assessed the effectiveness of SGLT2i post-ACS with new onset HF.

Hypothesis: SGLT2i use improves the effectiveness outcomes post-ACS induced new HF.

Methods: We conducted a retrospective observational cohort study that included all diabetic patients admitted to the main tertiary cardiology center in Qatar between 1/06/2017 and 1/06/2021 with ACS complicated by new HF defined as new clinical HF requiring diuretics during the index admission, or ejection fraction (EF) <40%. We divided the study population in two groups; (1) SGLT2i users; (2) non-SGLT2i users. Primary outcomes were evaluated at 30 and 360 days, including a composite of ACS, HF hospitalization, and all-cause mortality. A propensity score-matched model (1:1) was used to adjust for baseline characteristics between the study groups. Cox proportional hazard regression analysis was used to evaluate the outcomes. P-value <0.05 indicated statistical significance.

Results: We included 465 ACS patients who met the eligibility criteria (93% male, mean age 55±10 years, and 72% Asian). Using 1:1 propensity score matching, 78 patients were included per arm with an absolute standardized difference <0.1 for all baseline characteristics. The use of SGLT2i post ischemia-induced new HF resulted in lower composite outcomes at 30 and 360 days [ 30-day: 2.6% vs. 11.5%, HR= 0.20 (0.04-0.94), P =0.041; 360-Day: 14.1% vs. 23.1, HR= 0.46 (0.22-0.99), P= 0.046].

Conclusions: Our findings suggest cardioprotective effects of SGLT2i post-ACS induced new HF, which widens the SGLT2i spectrum of indications and may encourage cardiologists to prescribe SGLT2i for this population.

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