Impact of chronic GLP-1 RA and SGLT-2I therapy on in-hospital outcome of diabetic patients with acute myocardial infarction

Cardiovascular Diabetology

Research

Monica Ludergnani¹  Filippo Trombara¹  Paolo Poggio¹  Luigia Gionti¹  Stefano Genovese¹  Alice Bonomi¹  Giancarlo Marenzi¹  Piergiuseppe Agostoni²  Nicola Cosentino²  Maria Carla Roncaglioni³  Pierluca Colacioppo³  Marta Baviera³  Olivia Leoni⁴  Francesco Bortolan⁴ 

[1] Centro Cardiologico Monzino, I.R.C.C.S, Via Parea 4, 20138, Milan, Italy;Centro Cardiologico Monzino, I.R.C.C.S, Via Parea 4, 20138, Milan, Italy;Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy;Laboratory of Cardiovascular Prevention, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy;Regional Epidemiological Observatory, Lombardy Region, Milan, Italy;

关键词: Glucagon-like peptide-1 receptor agonists;    Sodium glucose cotransporter-2 inhibitors;    Diabetes mellitus;    Acute myocardial infarction;    In-hospital outcome;   

DOI  :  10.1186/s12933-023-01758-y

 received in 2022-11-11, accepted in 2023-01-27,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundGlucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium glucose cotransporter-2 inhibitors (SGLT-2i) demonstrated cardiovascular and renal protection. Whether their benefits occur also during hospitalization for acute myocardial infarction (AMI) in patients with diabetes mellitus (DM) is not known. We evaluated in-hospital outcomes of patients hospitalized with AMI according to their chronic use of GLP-1 RA and/or SGLT-2i.MethodsUsing the health administrative databases of Lombardy, patients hospitalized with AMI from 2010 to 2019 were included. They were stratified according to DM status, then grouped into three cohorts using a propensity score matching: non-DM patients; DM patients treated with GLP-1 RA and/or SGLT-2i; DM patients not treated with GLP-1 RA/SGLT-2i. The primary endpoint of the study was the composite of in-hospital mortality, acute heart failure, and acute kidney injury requiring renal replacement therapy.ResultsWe identified 146,798 patients hospitalized with AMI (mean age 71 ± 13 years, 34% females, 47% STEMI; 26% with DM). After matching, 3,090 AMI patients (1030 in each group) were included in the analysis. Overall, the primary endpoint rate was 16% (n = 502) and progressively increased from non-DM patients to DM patients treated with and without GLP-1 RA/SGLT-2i (13%, 16%, and 20%, respectively; P < 0.0001). Compared with non-DM patients, DM patients with GLP-1 RA/SGLT-2i had a 30% higher risk of the primary endpoint, while those not treated with GLP-1 RA/SGLT-2i had a 60% higher risk (P < 0.0001).ConclusionChronic therapy with GLP-1 RA and/or SGLT-2i has a favorable impact on the clinical outcome of DM patients hospitalized with AMI.

【 授权许可】

CC BY   
© The Author(s) 2023

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