AUTHOR=Rahhal Alaa , Hamamyh Tahseen , Chapra Ammar , Zaza Khaled J. , Najim Mostafa , Hemadneh Mohammad , Faraj Hazem , Kanjo Wael , Yasin Ahmed , Toba Haneen , Mohammed Wafa , Hamad Mohammad Khair , Al-Tikrety Nawras , Baraa Habib Mhd , Awaisu Ahmed , Mahfouz Ahmed , Alyafei Sumaya , Arabi Abdul Rahman , Patel Ashfaq , Al-Hijji Mohammed 

TITLE=Sodium–glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1383669

DOI=10.3389/fcvm.2024.1383669

ISSN=2297-055X

ABSTRACT=Background: Acute Coronary Syndrome (ACS) remains a risk factor for heart failure (HF). Therefore, we aimed to assess the cardio-protective role of sodium glucose cotransporter-2 (SGLT2) inhibitors post-ACS with acute HF (AHF) among patients with diabetes.We conducted a propensity score matching retrospective observational cohort study that included patients with diabetes admitted with ACS complicated by AHF defined as new clinical HF requiring diuretics during the index admission, or ejection fraction (EF) <40%. The study population was divided into two groups; (1) SGLT2 inhibitor users; and (2) SGLT2 inhibitor non-users. Cox proportional hazard regression analysis was used to evaluate the outcomes.Results: A total of 465 patients (93% male, mean age 55±10 years) were included. Using a 1:1 propensity score matching, 78 patients were included per arm with an absolute standardized difference of <0.1 for all baseline characteristics. SGLT2 inhibitors use resulted in lower composite outcomes of ACS, HF hospitalization, and all-cause mortality at 1 month and 12 months [1-month: 2.6% vs. 11.5%, HR= 0.20 (0.04-0.94), P =0.041; 12-month: 14.1% vs. 23.1%, HR= 0.46 (0.22-0.99), P =0.046].The findings suggest that SGLT2 inhibitors may confer cardio-protective effects in ACSinduced AHF, widening the spectrum for SGLT2 inhibitors indications.