DOI: 10.30565/medalanya.1955146 ISSN: 2587-0319

The Effect of SGLT2 Inhibitors on Antianginal Therapy Dynamics in Diabetic CABG Patients

Fahri Çakan, Ali Çoner, Ertan Akbay, Can Öncel, Cemal Köseoğlu
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Aim: Although SGLT2 inhibitors offer cardiovascular benefits in type 2 diabetes, their impact on antianginal therapy needs after CABG remains unclear. This study investigates the potential association between SGLT2i use and alterations in the frequency and intensity of antianginal regimens in these patients.Methods: This retrospective study included 125 diabetic patients ≥1 year post-CABG, divided into SGLT2i users (n=70) and non-users (n=55). Demographic characteristics, laboratory findings, comorbidities, and antianginal medication profiles were retrospectively analyzed. The primary outcomes were changes in the number and intensity of antianginal medications during follow-up. One-way analysis of covariance (ANCOVA) was performed to assess the independent effect of SGLT2i use after adjustment for potential confounders.Results: Baseline antianginal medication burden and treatment intensity were similar between groups (p>0.05). During follow-up, SGLT2i users demonstrated significantly greater reductions in ivabradine and ranolazine use compared with controls (p=0.035 and p=0.001, respectively). Patients receiving SGLT2i experienced a significantly greater reduction in both the total number of antianginal medications (–0.371 ± 0.66 vs. –0.036 ± 0.57; p=0.001) and overall treatment intensity (–0.52 ± 0.89 vs. –0.07 ± 0.79; p=0.001). After adjustment for age, sex, glomerular filtration rate, neutrophil count, and baseline medication burden, SGLT2i use remained independently associated with reduced antianginal medication number (F=7.175; p=0.009) and treatment intensity (F=8.106; p=0.005).Conclusion: SGLT2 inhibitor therapy was independently associated with a reduced antianginal treatment burden in diabetic CABG patients. These findings indicate a potential association between SGLT2i use and additional anti-ischemic benefits beyond glycemic control in chronic coronary syndrome management.

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