Cardiorenal protective effect of dapagliflozin in patients with acute ST-segment elevation myocardial infarction and type 2 diabetes mellitus
Liu Changchang
Wang Yanbo
Su Lifang
Zhou Qing
Tian Jia
Hao Guozhen
Gu Xinshun
Abstract：Objective To investigate the cardiorenal protective effect of dapagliflozin in patients with ST-segment elevation myocardial infarction(STEMI)complicated by type 2 diabetes mellitus(T2DM)in the real world.Methods The patients with STEMI complicated by T2DM received reperfusion therapy were selected from the Second Hospital of Hebei Medical University from Jan.1,2022 to Dec.31,2022.The patients were divided into dapagliflozin group and control group according to whether dapagliflozin was used within 24 h after admission,and they were followed up for 6 months.The composite endpoints of heart and kidney[including angina after myocardial infarction(MI),exacerbated heart failure(HF),cardiac death,and contrast-induced nephropathy(CIN)]during hospitalization,and major adverse cardiovascular and cerebrovascular events(MACCE)during 6-months follow-up period were observed.The influence of dapagliflozin on composite endpoints of heart and kidney during hospitalization was discussed by using single-factor and multi-factor Logistic regression analyses in patients with STEMI complicated by T2DM.Results There were totally 180 patients included,and 92 in dapagliflozin group and 88 in control group.The level of postoperative serum creatinine(SCr)was higher in control group than that in dapagliflozin group[6.0(-3.0～15.8)mol/L vs.-0.8(-8.41～13.5)mol/L,P=0.007].The total output was significantly higher in dapagliflozin group than that in control group(5394.7±2001.1 ml vs.4748.6±1360.9 ml,P=0.013).During 6-month follow-up period,level of fasting blood glucose(FBG)was lower in dapagliflozin group than that in control group[(6.6±1.8)mmol/L vs.(7.9±3.7)mmol/L,P=0.005].The incidence of composite endpoints of heart and kidney was lower in dapagliflozin group than that in control group during hospitalization(9.78%vs.23.86%,P=0.011).During 6-month follow-up period,the difference MACCE incidence had no statistical significance between 2 groups(8.43%vs.10.8%,P=0.599).The results of multi-factor Logistic regression analysis showed that smoking(OR=3.466,95%CI:1.196～10.042,P=0.022),dapagliflozin(OR=0.391,95%CI:0.161～0.953,P=0.039)and FBG at admission time(OR=3.146,95%CI:1.268～7.806,P=0.013)were influence factors for composite endpoints of heart and kidney in patients with STEMI complicated by T2DM.Conclusion For patients with STEMI complicated by T2DM,early administration of dapagliflozin-while ensuring timely restoration of blood flow in infarct-related artery-can effectively provide cardiorenal protection with a favorable safety profile.
Keywords：DapagliflozinST-segment elevation myocardial infarctionType 2 diabetes mellitusCardiorenal protective effect
Publication Date：2025-09-20
Online Publishing Date：2025-11-04(First online date of this platform, not the publication date of the document)
Pages：7( 1115-1121 )