Effect of Sodium Glucose Co-transporter Type 2 Inhibitors on The Infract size among Diabetic Patients With ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract

Background: Myocardial ischemia causes cell death, which sets off an inflammatory cascade that eventually leads to the formation of scars.Sodium-glucose co-transporter-2 inhibitors(SGLT2I) used in the management of patients with type 2 diabetes.Aim: Is to evaluate the long-term treatment with SGLT2I on decreasing the infarct size in STEMI diabetic patientswho undergoing primary percutaneous coronary intervention.methods: This Comparative study included 30 patients who were admitted with STEMI undergoing Primary PCI. Patients were divided equally into group(1) : diabetic patients not on SGLT2I & group 2 :diabetic patients on SGLT2I for more than 6 months. Baseline characteristics, echocardiographic parameters , angiographic and procedural data, medication use, and outcome data were recorded prospectively.Results: Regarding biomarkers, hs-TnI levels were significantly higher in non SGLT2I group compared to SGLT2I group (P<0.05).Furthermore, the angiography finding, TIMI flow after PCI was significantly improved in SGLT2I group compared to non SGLT2I group P=0.029. On hospital discharge, ST resolution and Ejection Fraction(EF) were significantly higher in SGLT2I group compared to non SGLT2I group P<0.001 ,also WMSI on hospital discharge was significantly higher in non SGLT2I group compared to SGLT2I group P=0.007 . Mitral regurgitation was significantly different between both groups, being significantly improved in SGLT2I group compared to non SGLT2I group P=0.003. Baseline EF, WMSI and mitral regurgitation were insignificantly different between both groups.Conclusion: Diabetic patients with STEMI undergoing PPCI and treated with SGLT2I exhibited significantly decreased the infract size and improved cardiovascular outcomes compared to those not on SGLT2Itherapy.