Effect of Dapagliflozin in Type II Diabetic Patients Presenting with Acute Myocardial Infarction and Stage B Heart Failure | ||||
| International Journal of Medical Arts | ||||
| Articles in Press, Accepted Manuscript, Available Online from 28 August 2025 PDF (766.01 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2025.397085.2204 | ||||
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| Authors | ||||
Ahmed Gamal Darwish  1; Ahmed AL-HABBAA 2; Ahmad Mohammad Hassaan3
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| 1Cardiology department, faculty of medicine, Al Azhar University, Cairo, Egypt. | ||||
| 2Cardiology department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| 3Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Patients with type II diabetes mellitus (T2DM) and acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) are at increased risk of major adverse cardiovascular events (MACE). Sodium-glucose co-transporter 2 (SGLT2) inhibitors like dapagliflozin have demonstrated cardiovascular benefits, yet their early impact post-PCI remains underexplored. Aim: To evaluate the effect of dapagliflozin on 30-day mortality and MACE in T2DM patients with AMI undergoing PCI and classified as stage B heart failure. Patients and Methods: This prospective comparative study enrolled 110 T2DM patients with AMI who underwent successful PCI and were classified as stage B heart failure. Patients were divided into two groups: dapagliflozin group (n=55) and control group (n=55). Baseline demographics, comorbidities, echocardiographic parameters, angiographic findings, and 30-day post-discharge outcomes were assessed and compared. Results: The two groups were matched in age, gender, and comorbidities (p > 0.05), except for a higher prevalence of smoking in the control group. Anterior STEMI was the most common presentation. PCI data showed similar use of single drug-eluting stents (p = 0.6) and LAD as the most affected vessel. Echocardiographic assessments revealed comparable ejection fraction and diastolic dysfunction between groups. At 30-day follow-up, no significant difference was noted in mortality (3.6% vs. 5.5%), recurrent MI (1.8% vs. 1.8%), stroke (1.8% vs. 1.8%), heart failure symptoms (7.3% vs. 14.5%), or admissions due to heart failure (3.6% vs. 7.3%). No dapagliflozin-related adverse events were observed. Conclusion: Although this study did not find a statistically significant reduction in early post-discharge cardiovascular events with dapagliflozin in stage B heart failure patients with type 2 diabetes and acute myocardial infarction, previous research indicates a potentially beneficial trend that may become clearer with larger cohorts and extended follow-up. The growing evidence supporting the cardio-renal benefits of SGLT2 inhibitors warrants further investigation into their early use post-AMI. | ||||
| Keywords | ||||
| Dapagliflozin; Acute Myocardial Infarction; Percutaneous Coronary Intervention; Type 2 Diabetes Mellitus | ||||
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