Sodium-glucose cotransporter 2 inhibitor use in early-phase acute coronary syndrome with severe heart failure.
Eur Heart J Cardiovasc Pharmacother
; 9(5): 444-452, 2023 07 29.
Article
en En
| MEDLINE
| ID: mdl-37173281
ABSTRACT
AIMS:
Sodium-glucose cotransporter 2 inhibitor (SGLT2i) improves clinical outcomes in patients with heart failure (HF), but has limited evidence of SGLT2i use in early-phase acute coronary syndrome (ACS). We determined association of early SGLT2i use compared with either non-SGLT2i or dipeptidyl peptidase 4 inhibitor (DPP4i) use in hospitalized patients with ACS. METHODS ANDRESULTS:
This retrospective cohort study that used the Japanese nationwide administrative claims database included patients hospitalized with ACS aged ≥20 years between April 2014 and March 2021. The primary outcome was a composite of all-cause mortality or HF/ACS rehospitalization. Using 11 propensity score matching, the association with outcomes of the early SGLT2i use (≤14 days after admission) compared with non-SGLT2i or DPP4i use was determined according to the HF treatment. Among 388 185 patients included 115 612 and 272 573 with and without severe HF, respectively. Compared to non-SGLT2i users, the SGLT2i users had a lower hazard ratio (HR) with the primary outcome [HR 0.83, 95% confidence interval (CI) 0.76-0.91; P < 0.001] in the severe HF group; however, there was no significant difference in the non-severe HF group (HR 0.92, 95% CI 0.82-1.03; P = 0.16). SGLT2i use showed a lower risk of the outcome in patients with severe HF and diabetes compared with DPP4i use (HR 0.83, 95% CI 0.69-1.00; P = 0.049).CONCLUSION:
SGLT2i use in patients with early-phase ACS showed a lower risk of primary outcome in patients with severe HF, but the effect was not apparent in patients without severe HF.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Síndrome Coronario Agudo
/
Inhibidores de la Dipeptidil-Peptidasa IV
/
Insuficiencia Cardíaca
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Eur Heart J Cardiovasc Pharmacother
Año:
2023
Tipo del documento:
Article
País de afiliación:
Japón