Objective:To explore the efficacy and safety of sodium-glucose co-transporter-2 inhibitor(SGLT2i)in patients with acute myocardial infarction(AMI)complicated with Type 2 diabetes mellitus(T2DM).Methods:The study collected 2170 AMI patients with T2DM who underwent PCI at Anzhen Hospital affiliated to Capital Medical University from January 2018 to January 2023,of which 357 patients were treated with SGLT2i.Patients were divided into two groups according to whether they used SGLT2i or not:SGLT2i group and routine drug group and matched 1:1 according to the propensity score matching.The primary efficacy outcome was major adverse cardiovascular events(MACE)within 12 months after PCI,including all-cause death,non-fatal myocardial infarction,or ischemia-driven revascularization.The primary safety outcome was major bleeding.Results:After propensity score matching,357 patients in the SGLT2i group and routine drug group were included in the final analysis,and the difference of baseline characteristics was not observed with no statistical significance.The average follow-up period was(11.7±1.4)months.Compared to the routine drug group,the incidence of the primary effective endpoint events in the SGLT2i group was lower(HR=0.47,95％CI:0.27-0.81,P=0.006).And the incidence of ischemia-driven revascularization(HR=0.53,95％CI:0.30-0.93,P=0.026)was also lower in the Dapagliflozin group.There was no significant difference in the incidence of major safety outcome(HR=0.72,95％CI:0.29-1.81,P=0.492),all-cause death(HR=0.49,95％CI:0.23-1.06,P=0.069)and myocardial infarction(HR=0.62,95％CI:0.32-1.18,P=0.142)between the two groups.Conclusions:SGLT2i reduces the incidence of MACE,myocardial infarction or ischemia-related revascularization in patients with AMI complicated with T2DM without increasing the risk of safety events.
维普
万方数据