Effect of Sodium Glucose Co-transporter Type 2 Inhibitors on The Infract size among Diabetic Patients with ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract

Background: Myocardial ischemia causes cell death, which sets off an inflammatory cascade that eventually leads to the formation of scars.Sodium-glucose co-transporter-2 inhibitors(SGLT2I) used in the management of patients with type 2 diabetes.

Aim: Is to evaluate  the long-term treatment with SGLT2I on decreasing the infarct size in STEMI diabetic patientswho undergoing primary percutaneous  coronary intervention.

Methods: This Comparative study included 30 patients who were admitted with STEMI undergoing Primary PCI.  Patients were divided equally into group(1) included diabetic patients not on SGLT2I & group 2 included diabetic patients on SGLT2I for  more than 6 months. Baseline characteristics, echocardiographic parameters , angiographic and procedural data, medication use, and  outcome data were recorded prospectively.

Results: Regarding cardiac biomarkers, hs-TnI levels were significantly higher in non SGLT2I  group compared to SGLT2I group (5467.4 ± 2210.42 Vs. 1325.7 ± 562.39, P<0.05, respectively).Furthermore, the angiography finding, TIMI  flow after PCI was significantly improved in SGLT2I group compared to non SGLT2I group (2.1 ± 0.74 Vs. 1.4 ± 0.99, P=0.029, respectively),  with no significant difference between both groups regarding other angiography findings. On hospital discharge, ST resolution and Ejection Fraction(EF) were significantly improved in SGLT2I group compared to non SGLT2I group (54.7 ± 1.87, 13 (86.67%)Vs. 50.3 ± 2.38, 8  (53.33%),P<0.001, 0.046, respectively) ,also WMSI on hospital discharge was significantly higher in non SGLT2I group compared to  SGLT2I group (1.63 ± 0.38Vs. 1.30 ± 0.22, P=0.007 respectively). Mitral regurgitation was significantly different between both groups, being  significantly improved in SGLT2I group compared to non SGLT2I group (2(13.33%) Vs. 8(53.33%),P=0.003,respectively). Baseline EF,  Q wave, WMSI and mitral regurgitation were insignificantly different between both groups.

Conclusion: Diabetic patients with STEMI  undergoing PPCI and treated with SGLT2I exhibited significantly decreased the infract size and improved cardiovascular outcomes  compared to those not on SGLT2Itherapy.