Comparison of SGLT2 inhibitors with DPP4 inhibitors combined with metformin in patients with acute myocardial infarction and diabetes mellitus (vol 22, 185, 2023)

被引:0
|
作者
Lyu, Young Sang [1 ]
Oh, Seok [2 ]
Kim, Jin Hwa [1 ]
Kim, Sang Yong [1 ]
Jeong, Myung Ho [2 ,3 ]
机构
[1] Chosun Univ Hosp, Dept Internal Med, Div Endocrinol & Metab, Gwangju, South Korea
[2] Chonnam Natl Univ Hosp, Departmnent Cardiol, Gwangju, South Korea
[3] Chonnam Natl Univ, Med Sch, Dept Cardiol, Gwangju, South Korea
关键词
Antidiabetic agents; Diabetes mellitus; Hypoglycemic agents; Myocardial infarction;
D O I
10.1186/s12933-023-01960-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Although sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiovascular benefits in patients with type 2 diabetes mellitus, real-world evidence regarding their benefits to diabetic patients with acute myocardial infarction (AMI) is insufficient. This study evaluated cardiovascular outcomes by comparing SGLT2i with dipeptidyl peptidase-4 inhibitors (DPP-4i) in combination with metformin in diabetic patients with AMI. Methods: This study involved 779 diabetic participants with AMI from a Korean nationwide multicenter observational cohort, who were divided into two groups: (1) metformin plus SGLT2i group (SGLT2i group, n = 186) and (2) metformin plus DPP-4i (DPP-4i group, n = 593). The primary endpoint was one year of major adverse composite events (MACEs), a composite outcome of all-cause mortality, non-fatal myocardial infarction, any revascularization, cerebrovascular accident, and stent thrombosis. To balance the baseline differences, inverse probability of treatment weighting (IPTW) was performed. Results: After IPTW, the rate of MACEs in the SGLT2i group was not significantly lower than that in the DPP-4i group (hazard ratio [HR], 0.99; 95% confidence interval [Cl], 0.46 to 2.14, p = 0.983). In the unadjusted and adjusted analyses, all items for clinical outcomes were comparable between the two groups. In our exploratory analysis, the left ventricular ejection fraction showed a significant improvement in the SGLT2i group than in the DPP-4i group before achieving statistical balancing (6.10 ± 8.30 versus 2.95 ± 10.34, p = 0.007) and after IPTW adjustment (6.91 ± 8.91 versus 3.13 ± 10.41, p = 0.027). Conclusions: Our findings demonstrated that SGLT2i did not influence the rate of MACEs compared with DPP-4i in combination with metformin in diabetic patients with AMI but did improve left ventricular ejection fraction. Trial registration: Not applicable (retrospectively registered). © 2023, The Author(s).
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