Local experience of the use of type 2 sodium-glucose co-transporter inhibitors in patients with type 2 diabetes mellitus and acute coronary syndrome
https://doi.org/10.21886/2712-8156-2024-5-3-28-35
Abstract
Objective: to evaluate the course and outcomes of ACS in patients with type 2 diabetes taking SGLT-2 inhibitors. Materials and methods: the study included patients admitted to the Research Institute – Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky” Krasnodar from 01.11.2023 to 01.02.2024. Results: a retrospective analysis of medical documentation revealed that the number of patients with ACS while taking NGLT-2 inhibitors was significantly lower compared to those taking other glucose-lowering therapy. Patients taking iNGLT-2 had a significantly lower body mass index. Significant differences concern markers of liver dysfunction and microalbuminuria, which were significantly lower in the group receiving NGLT-2. In addition, these patients were less likely to experience hospital complications such as acute kidney injury, cardiac arrhythmias, ischemic stroke, left ventricular thrombus formation, and death. Conclusions: the results of local experience with the use of iNGLT-2 in hospitalized patients with type 2 diabetes and ACS are presented, confirming the metabolic and cardiorenal benefits of this class of drugs in real clinical practice. In addition, the study results clearly demonstrate a more stable course of ACS and a lower risk of in-hospital complications and mortality. However, these parameters did not achieve statistically significant results due to the small sample.
About the Authors
Z. G. Tatarintseva
Scientific Research Institute – Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky ; Kuban State Medical University
Russian Federation
Russian Federation
Zoya G. Tatarintseva, Head of the Department of Cardiology
Krasnodar
E. D. Kosmacheva
Scientific Research Institute – Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky ; Kuban State Medical University
Russian Federation
Russian Federation
Elena D. Kosmacheva, Dr. Sci. (Med.), Professor, Head of the Department of Therapy No. 1 of the Faculty of Advanced Training and Professional Retraining of Specialists; Deputy Chief Physician for the Medical Department
Krasnodar
Yu. A. Katushkina
Scientific Research Institute – Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky ; Kuban State Medical University
Russian Federation
Russian Federation
Yuliya A. Katushkina, endocrinologist of the endocrinology
department; Assistant of the Department of Therapy No. 1 of the Faculty of Advanced Training and Professional Retraining of Specialists
Krasnodar
K. O. Barbukhatti
Scientific Research Institute – Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky ; Kuban State Medical University
Russian Federation
Russian Federation
Kirill O. Barbukhatti, Dr. Sci. (Med.), Professor, Head of the Department of Cardiac Surgery No. 2; Head of the Department of Cardiac Surgery and Cardiology of the Faculty of Advanced Training and Professional Retraining of Specialists
Krasnodar
O. V. Babicheva
Scientific Research Institute – Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky ; Kuban State Medical University
Russian Federation
Russian Federation
Olga V. Babicheva, Cand. Sci. (Med.), cardiologist; Associate Professor of the Department of Cardiac Surgery and Cardiology of the Faculty of Training and Teaching Staff
Krasnodar
References
1. Avogaro A, Bonora E, Consoli A, Del Prato S, Genovese S, Giorgino F. Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome. Diab Vasc Dis Res. 2019;16(5):399-414. DOI: 10.1177/1479164119845612
2. Lin YT, Chen HA, Wu HY, Fan CM, Hsu JC, Chen KC. Influence of the Door-to-ECG Time on the Prognosis of Patients with Acute Coronary Syndrome. Acta Cardiol Sin. 2023;39(1):127-134. DOI: 10.6515/ACS.202301_39(1).20220602B
3. Ram E, Sternik L, Klempfner R, Iakobishvili Z, Fisman EZ, Tenenbaum A, et al. Type 2 diabetes mellitus increases the mortality risk after acute coronary syndrome treated with coronary artery bypass surgery. Cardiovasc Diabetol. 2020;19(1):86. DOI: 10.1186/s12933-020-01069-6
4. Bora S, Shankarrao Adole P. Carbonyl stress in diabetics with acute coronary syndrome. Clin Chim Acta. 2021;520:78-86. DOI: 10.1016/j.cca.2021.06.002
5. Lin CC, Lee PY, Chen KC, Liao PC, Hsu JC, Li AH. Clinical, Demographic, and Biochemical Characteristics of Patients with Acute ST-Segment Elevation Myocardial Infarction: An Analysis of Acute Coronary Syndrome Registry Data of a Single Medical Center from 2005 to 2016. Acta Cardiol Sin. 2020;36(1):1-7. DOI: 10.6515/ACS.202001_36(1).20190704D
6. Koufakis T, Karangelis D, Androutsopoulou V, Mikroulis D, Kotsa K. Management of Type 2 Diabetes in Acute Coronary Syndromes: Current State and Future Perspectives. Curr Pharm Des. 2023;29(5):365-367. DOI: 10.2174/1381612829666230210161306
7. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-2128. DOI: 10.1056/NEJMoa1504720
8. Ziyrek M., Duran M. Effects of SGLT2 Inhibitors as an Add-on Therapy to Metformin on Electrocardiographic Indices of Ventricular Repolarization. Acta Cardiol Sin. 2021;(37):327–328. DOI: 10.6515/ACS.202105_37(3).20210308B
9. Zelniker TA, Braunwald E. Clinical Benefit of Cardiorenal Effects of Sodium-Glucose Cotransporter 2 Inhibitors: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75(4):435-447. DOI: 10.1016/j.jacc.2019.11.036
10. Fonseca-Correa JI, Correa-Rotter R. Sodium-Glucose Cotransporter 2 Inhibitors Mechanisms of Action: A Review. Front Med (Lausanne). 2021;8:777861. DOI: 10.3389/fmed.2021.777861
11. Chang TY, Lu CT, Huang HL, Chou RH, Chang CC, Liu CT, et al. Association of Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor Use With Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus Patients With Stabilized Acute Myocardial Infarction: A Propensity Score Matching Study. Front Cardiovasc Med. 2022;9:882181. DOI: 10.3389/fcvm.2022.882181
12. Kim CH, Hwang IC, Choi HM, Ahn CH, Yoon YE, Cho GY. Differential cardiovascular and renal benefits of SGLT2 inhibitors and GLP1 receptor agonists in patients with type 2 diabetes mellitus. Int J Cardiol. 2022;364:104-111. DOI: 10.1016/j.ijcard.2022.06.027
13. Savage P, Cox B, Linden K, Coburn J, Shahmohammadi M, Menown I. Advances in Clinical Cardiology 2021: A Summary of Key Clinical Trials. Adv Ther. 2022;39(6):2398-2437. DOI: 10.1007/s12325-022-02136-y
14. Salukhov V.V., Galstyan G.R., Ilyinskay T.A. Practical aspects of initiation and use of SGLT2 inhibitors: inpatient and outpatient perspectives. Diabetes mellitus. 2022;25(3):275-287. (In Russ.) DOI: 10.14341/DM12855
15. Lopaschuk GD, Verma S. Mechanisms of Cardiovascular Benefits of Sodium Glucose Co-Transporter 2 (SGLT2) Inhibitors: A State-of-the-Art Review. JACC Basic Transl Sci. 2020;5(6):632-644. DOI: 10.1016/j.jacbts.2020.02.004
16. Vallon V, Verma S. Effects of SGLT2 Inhibitors on Kidney and Cardiovascular Function. Annu Rev Physiol. 2021;83:503-528. DOI: 10.1146/annurev-physiol-031620-095920
17. Cowie MR, Fisher M. SGLT2 inhibitors: mechanisms of cardiovascular benefit beyond glycaemic control. Nat Rev Cardiol. 2020;17(12):761-772. DOI: 10.1038/s41569-020-0406-8
18. Mkrtumyan A.M., Markova T.N., Mishchenko N.K. Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitors. Diabetes mellitus. 2021;24(3):291-299. (In Russ.) DOI: 10.14341/DM12541
19. Salukhov V.V., Kotova M.E. Main effects caused by SGLT2 inhibitors in patients with type 2 diabetes and the mechanisms that determine them. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2019;8(3):61–74. (In Rus) DOI: 10.24411/2304-9529-2019-13007
20. Kosiborod M, Lam CSP, Kohsaka S, Kim DJ, Karasik A, Shaw J, et al. Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL 2 Study. J Am Coll Cardiol. 2018;71(23):2628-2639. DOI: 10.1016/j.jacc.2018.03.009
21. Lin TK, Lee MC, Cheng YH, Ma T, Chen MC, Yang TY, et al. The association between SGLT2 inhibitors and new-onset acute coronary syndrome in the elderly: a populationbased longitudinal cohort study. Diabetol Metab Syndr. 2023;15(1):170. DOI: 10.1186/s13098-023-01143-5
22. Andreadou I, Bell RM, Bøtker HE, Zuurbier CJ. SGLT2 inhibitors reduce infarct size in reperfused ischemic heart and improve cardiac function during ischemic episodes in preclinical models. Biochim Biophys Acta Mol Basis Dis. 2020;1866(7):165770. DOI: 10.1016/j.bbadis.2020.165770
23. von Lewinski D, Benedikt M, Tripolt N, Wallner M, Sourij H, Kolesnik E. Can sodium-glucose cotransporter 2 inhibitors be beneficial in patients with acute myocardial infarction? Kardiol Pol. 2021;79(5):503-509. DOI: 10.33963/KP.15969
Review
For citations:
Tatarintseva Z.G., Kosmacheva E.D., Katushkina Yu.A., Barbukhatti K.O., Babicheva O.V. Local experience of the use of type 2 sodium-glucose co-transporter inhibitors in patients with type 2 diabetes mellitus and acute coronary syndrome. South Russian Journal of Therapeutic Practice. 2024;5(3):28-35. (In Russ.) https://doi.org/10.21886/2712-8156-2024-5-3-28-35
Views:
160
Email this article 