Administration of Sodium-Glucose Cotransporter-2 Inhibitors Following Acute Myocardial Infarction: A Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Trials
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Objective: Individuals with acute myocardial infarction (AMI) face a considerable mortality risk.Recent evidence suggests that sodium-glucose cotransporter-2 inhibitors (SGLT-2i) may provide cardioprotective benefits, particularly in cases of heart failure (HF).However, the evidence regarding SGLT-2i use in AMI patients remains contradictory and ambiguous.This study investigates the efficacy and safety of SGLT-2i administration following AMI.Methods: We systematically searched Scopus, Cochrane Library, MEDLINE, and ClinicalTrials.govfor potential articles using specific keywords, with the search extending until December 15th, 2024.All published randomized controlled trials (RCTs) assessing SGLT-2i use following AMI were included.Outcomes were expressed as risk ratios (RRs) and standardized mean differences.Results: A total of 7 RCTs were included.Our pooled analysis demonstrated that SGLT-2i administration post-AMI was associated with a reduced risk of HF hospitalization (RR, 0.72; 95% confidence interval [CI], 0.60, 0.86; p=0.0004,I 2 =0%) and an improved left ventricular ejection fraction (LVEF) (SMD, 0.29; 95% CI, 0.03, 0.55; p=0.03;I 2 =60%) compared with placebo.However, there were no significant differences in all-cause mortality (p=0.94),cardiovascular (CV)-related mortality (p=0.77),stroke/transient ischemic attack (p=0.17), or major adverse CV events (p=0.16).The incidences of serious adverse events, diabetic ketoacidosis, and urinary tract infections were comparable between the 2 groups.Conclusion: The administration of SGLT-2i following AMI may reduce the risk of HF hospitalization and improve LVEF, without affecting mortality outcomes.Overall, SGLT-2i proved to be a comparatively safe treatment option.
Institution: Pelita Harapan University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414518763