Author:
Lin Tsung-Kun,Lee Mei-Chun,Cheng Yu-Han,Ma Timothy,Chen Mei-Chun,Yang Tsung-Yuan,Jong Gwo-Ping
Abstract
Abstract
Background
Several observational cohorts and meta-analytical studies on humans have shown that users of sodium-glucose cotransporter-2 inhibitors (SGLT2is) have a lower risk for new-onset acute coronary syndrome (ACS) than nonusers. However, some studies, including randomized clinical trials, reported the opposite results. This study aimed to investigate the impacts of a SGLT2i on new-onset ACS in a population.
Methods
We conducted a retrospective population-based cohort study involving 56,356 subjects who received SGLT2i therapy and 112,712 patients who did not receive SGLT2i therapy between May 1, 2016 and December 31, 2019. The outcome was the risk of new-onset ACS. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals for associations between SGLT2i use and ACS risk.
Results
A total of 670 and 1408 ACS events occurred in SGLT2i users and nonusers, respectively, during a follow-up of 3.7 years. SGLT2i use was associated with a nonsignificantly lower risk of ACS (adjusted HR 0.95, 95%confidence intervals (CI 0.87–1.04, P = 0.3218). We confirmed the robustness of these results through a propensity score 1:1 matching analysis. The results of the subgroup analysis of the subtype of the SGLT2i treatments were consistent with the main findings. An increased risk for the incidence of ACS in male and older (> 70 years) patients were also found.
Conclusions
In this population-based cohort study, we found that SGLT2i use is associated with a nonsignificantly decreased risk of ACS. No difference in the SGLT2i subtype was observed in subgroup analyses. However, the results of this study indicated an increased risk for the incidence of ACS in male and older (> 70 years) patients.
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology, Diabetes and Metabolism,Internal Medicine
Reference29 articles.
1. Avogaro A, Bonora E, Consoli A, et al. Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome. Diab Vasc Dis Res. 2019;16(5):399–414.
2. Lin YT, Chen HA, Wu HY, et al. Influence of the Door-to-ECG Time on the Prognosis of Patients with Acute Coronary Syndrome. Acta Cardiol Sin. 2023;39:127–34.
3. Ram E, Sternik L, Klempfner R, et al. Type 2 diabetes mellitus increases the mortality risk after acute coronary syndrome treated with coronary artery bypass surgery. Cardiovasc Diabetol. 2020;19(1):86.
4. Bora S, Shankarrao AP. Carbonyl stress in diabetics with acute coronary syndrome. Clin Chim Acta. 2021;520:78–86.
5. Lin CC, Lee PY, Chen KC, et al. Clinical, Demographic, and biochemical characteristics of patients with acute ST-segment elevation myocardial infarction: An analysis of acute coronary syndrome registry data of a single medical center from 2005 to 2016. Acta Cardiol Sin. 2020;36:1–7.
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