Sodium–glucose cotransporter 2 inhibitor use in early-phase acute coronary syndrome with severe heart failure
Authors' 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.
Study context
- Population
- Patients aged ≥20 years hospitalized with acute coronary syndrome (ACS), Japanese nationwide claims database, April 2014–March 2021115,612 with severe heart failure (HF)
- Participants
- 388,185 patients
- Exposure
- Early SGLT2 inhibitor use vs non-SGLT2 inhibitor or DPP4 inhibitor use
- Outcome
- Composite of:
- All-cause mortality
- HF/ACS rehospitalization
Methodological detailspropensity-score matched, nationwide administrative claims database
- Propensity-score matched
- Nationwide administrative claims database
Main finding
As reported in the abstract
Primary composite outcome, by HF severity
SGLT2i vs Non-SGLT2iHazard ratio (95% CI)P value
Severe HF
0.83(0.76–0.91)
P < 0.001Non-severe HF
0.92(0.82–1.03)
P = 0.16Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Primary outcome, severe HF and diabetesSGLT2ivs DPP4i | 0.83 (0.69–1.00) | P = 0.049 | |
| 0.512Hazard ratio (log scale) |
Original publication
Sodium–glucose cotransporter 2 inhibitor use in early-phase acute coronary syndrome with severe heart failure. Eur Heart J Cardiovasc Pharmacother. Published 12 May 2023. doi:10.
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