In-hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: Insights from the SGLT2-I AMI PROTECT study
BackgroundSodium-glucose co-transporter 2 inhibitors (SGLT2-i) have shown significant cardiovascular benefits in patients with and without type 2 diabetes mellitus (T2DM). They have also gained interest for their potential anti-arrhythmic role and their ability to reduce the occurrence of atrial fib...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1012220/full |
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| author | Arturo Cesaro Arturo Cesaro Felice Gragnano Felice Gragnano Pasquale Paolisso Pasquale Paolisso Luca Bergamaschi Luca Bergamaschi Emanuele Gallinoro Emanuele Gallinoro Celestino Sardu Niya Mileva Alberto Foà Alberto Foà Matteo Armillotta Matteo Armillotta Angelo Sansonetti Angelo Sansonetti Sara Amicone Sara Amicone Andrea Impellizzeri Andrea Impellizzeri Giuseppe Esposito Giuseppe Esposito Nuccia Morici Jacopo Andrea Oreglia Gianni Casella Ciro Mauro Dobrin Vassilev Nazzareno Galie Nazzareno Galie Gaetano Santulli Gaetano Santulli Gaetano Santulli Carmine Pizzi Carmine Pizzi Emanuele Barbato Emanuele Barbato Paolo Calabrò Paolo Calabrò Raffaele Marfella Raffaele Marfella |
| author_facet | Arturo Cesaro Arturo Cesaro Felice Gragnano Felice Gragnano Pasquale Paolisso Pasquale Paolisso Luca Bergamaschi Luca Bergamaschi Emanuele Gallinoro Emanuele Gallinoro Celestino Sardu Niya Mileva Alberto Foà Alberto Foà Matteo Armillotta Matteo Armillotta Angelo Sansonetti Angelo Sansonetti Sara Amicone Sara Amicone Andrea Impellizzeri Andrea Impellizzeri Giuseppe Esposito Giuseppe Esposito Nuccia Morici Jacopo Andrea Oreglia Gianni Casella Ciro Mauro Dobrin Vassilev Nazzareno Galie Nazzareno Galie Gaetano Santulli Gaetano Santulli Gaetano Santulli Carmine Pizzi Carmine Pizzi Emanuele Barbato Emanuele Barbato Paolo Calabrò Paolo Calabrò Raffaele Marfella Raffaele Marfella |
| author_sort | Arturo Cesaro |
| collection | DOAJ |
| description | BackgroundSodium-glucose co-transporter 2 inhibitors (SGLT2-i) have shown significant cardiovascular benefits in patients with and without type 2 diabetes mellitus (T2DM). They have also gained interest for their potential anti-arrhythmic role and their ability to reduce the occurrence of atrial fibrillation (AF) and ventricular arrhythmias (VAs) in T2DM and heart failure patients.ObjectivesTo investigate in-hospital new-onset cardiac arrhythmias in a cohort of T2DM patients presenting with acute myocardial infarction (AMI) treated with SGLT2-i vs. other oral anti-diabetic agents (non-SGLT2-i users).MethodsPatients from the SGLT2-I AMI PROTECT registry (NCT05261867) were stratified according to the use of SGLT2-i before admission for AMI, divided into SGLT2-i users vs. non-SGLT2-i users. In-hospital outcomes included the occurrence of in-hospital new-onset cardiac arrhythmias (NOCAs), defined as a composite of new-onset AF and sustained new-onset ventricular tachycardia (VT) and/or ventricular fibrillation (VF) during hospitalization.ResultsThe study population comprised 646 AMI patients categorized into SGLT2-i users (111 patients) and non-SGLT2-i users (535 patients). SGLT2-i users had a lower rate of NOCAs compared with non-SGLT2-i users (6.3 vs. 15.7%, p = 0.010). Moreover, SGLT2-i was associated with a lower rate of AF and VT/VF considered individually (p = 0.032). In the multivariate logistic regression model, after adjusting for all confounding factors, the use of SGLT2-i was identified as an independent predictor of the lower occurrence of NOCAs (OR = 0.35; 95%CI 0.14–0.86; p = 0.022). At multinomial logistic regression, after adjusting for potential confounders, SGLT2-i therapy remained an independent predictor of VT/VF occurrence (OR = 0.20; 95%CI 0.04–0.97; p = 0.046) but not of AF occurrence.ConclusionsIn T2DM patients, the use of SGLT2-i was associated with a lower risk of new-onset arrhythmic events during hospitalization for AMI. In particular, the primary effect was expressed in the reduction of VAs. These findings emphasize the cardioprotective effects of SGLT2-i in the setting of AMI beyond glycemic control.Trial registrationData are part of the observational international registry: SGLT2-I AMI PROTECT. ClinicalTrials.gov, identifier: NCT05261867. |
| first_indexed | 2024-04-12T03:07:03Z |
| format | Article |
| id | doaj.art-5d61f0e9e1c946a8843c9276386eddcc |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T03:07:03Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-5d61f0e9e1c946a8843c9276386eddcc2022-12-22T03:50:28ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-09-01910.3389/fcvm.2022.10122201012220In-hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: Insights from the SGLT2-I AMI PROTECT studyArturo Cesaro0Arturo Cesaro1Felice Gragnano2Felice Gragnano3Pasquale Paolisso4Pasquale Paolisso5Luca Bergamaschi6Luca Bergamaschi7Emanuele Gallinoro8Emanuele Gallinoro9Celestino Sardu10Niya Mileva11Alberto Foà12Alberto Foà13Matteo Armillotta14Matteo Armillotta15Angelo Sansonetti16Angelo Sansonetti17Sara Amicone18Sara Amicone19Andrea Impellizzeri20Andrea Impellizzeri21Giuseppe Esposito22Giuseppe Esposito23Nuccia Morici24Jacopo Andrea Oreglia25Gianni Casella26Ciro Mauro27Dobrin Vassilev28Nazzareno Galie29Nazzareno Galie30Gaetano Santulli31Gaetano Santulli32Gaetano Santulli33Carmine Pizzi34Carmine Pizzi35Emanuele Barbato36Emanuele Barbato37Paolo Calabrò38Paolo Calabrò39Raffaele Marfella40Raffaele Marfella41Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli', Naples, ItalyDivision of Cardiology, A.O.R.N. “Sant'Anna e San Sebastiano”, Caserta, ItalyDepartment of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli', Naples, ItalyDivision of Cardiology, A.O.R.N. “Sant'Anna e San Sebastiano”, Caserta, ItalyCardiovascular Center Aalst, OLV-Clinic, Aalst, BelgiumDepartment of Advanced Biomedical Sciences, University Federico II, Naples, ItalyCardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, ItalyDepartment of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli', Naples, ItalyCardiovascular Center Aalst, OLV-Clinic, Aalst, BelgiumDepartment of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, ItalyCardiology Clinic, “Alexandrovska” University Hospital, Medical University of Sofia, Sofia, BulgariaCardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, ItalyCardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, ItalyCardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, ItalyCardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, ItalyCardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, ItalyDepartment of Advanced Biomedical Sciences, University Federico II, Naples, ItalyInterventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy0IRCCS S. Maria Nascente - Fondazione Don Carlo Gnocchi ONLUS, Milan, ItalyInterventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy1Unit of Cardiology, Maggiore Hospital, Bologna, Italy2Department of Cardiology, Hospital Cardarelli, Naples, Italy3Medica Cor Hospital, Ruse, BulgariaCardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, ItalyDepartment of Advanced Biomedical Sciences, University Federico II, Naples, Italy4International Translational Research and Medical Education (ITME) Consortium, Naples, Italy5Department of Medicine (Division of Cardiology) and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Einstein-Sinai Diabetes Research Center, The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, New York, NY, United StatesCardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, ItalyCardiovascular Center Aalst, OLV-Clinic, Aalst, BelgiumDepartment of Advanced Biomedical Sciences, University Federico II, Naples, ItalyDepartment of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli', Naples, ItalyDivision of Cardiology, A.O.R.N. “Sant'Anna e San Sebastiano”, Caserta, ItalyDepartment of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy6Mediterranea Cardiocentro, Naples, ItalyBackgroundSodium-glucose co-transporter 2 inhibitors (SGLT2-i) have shown significant cardiovascular benefits in patients with and without type 2 diabetes mellitus (T2DM). They have also gained interest for their potential anti-arrhythmic role and their ability to reduce the occurrence of atrial fibrillation (AF) and ventricular arrhythmias (VAs) in T2DM and heart failure patients.ObjectivesTo investigate in-hospital new-onset cardiac arrhythmias in a cohort of T2DM patients presenting with acute myocardial infarction (AMI) treated with SGLT2-i vs. other oral anti-diabetic agents (non-SGLT2-i users).MethodsPatients from the SGLT2-I AMI PROTECT registry (NCT05261867) were stratified according to the use of SGLT2-i before admission for AMI, divided into SGLT2-i users vs. non-SGLT2-i users. In-hospital outcomes included the occurrence of in-hospital new-onset cardiac arrhythmias (NOCAs), defined as a composite of new-onset AF and sustained new-onset ventricular tachycardia (VT) and/or ventricular fibrillation (VF) during hospitalization.ResultsThe study population comprised 646 AMI patients categorized into SGLT2-i users (111 patients) and non-SGLT2-i users (535 patients). SGLT2-i users had a lower rate of NOCAs compared with non-SGLT2-i users (6.3 vs. 15.7%, p = 0.010). Moreover, SGLT2-i was associated with a lower rate of AF and VT/VF considered individually (p = 0.032). In the multivariate logistic regression model, after adjusting for all confounding factors, the use of SGLT2-i was identified as an independent predictor of the lower occurrence of NOCAs (OR = 0.35; 95%CI 0.14–0.86; p = 0.022). At multinomial logistic regression, after adjusting for potential confounders, SGLT2-i therapy remained an independent predictor of VT/VF occurrence (OR = 0.20; 95%CI 0.04–0.97; p = 0.046) but not of AF occurrence.ConclusionsIn T2DM patients, the use of SGLT2-i was associated with a lower risk of new-onset arrhythmic events during hospitalization for AMI. In particular, the primary effect was expressed in the reduction of VAs. These findings emphasize the cardioprotective effects of SGLT2-i in the setting of AMI beyond glycemic control.Trial registrationData are part of the observational international registry: SGLT2-I AMI PROTECT. ClinicalTrials.gov, identifier: NCT05261867.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1012220/fullsodium-glucose cotransporter 2 inhibitors (SGLT2-i)acute myocardial infarctionatrial fibrillationventricular arrhythmiasventricular tachycardiahyperglycemia |
| spellingShingle | Arturo Cesaro Arturo Cesaro Felice Gragnano Felice Gragnano Pasquale Paolisso Pasquale Paolisso Luca Bergamaschi Luca Bergamaschi Emanuele Gallinoro Emanuele Gallinoro Celestino Sardu Niya Mileva Alberto Foà Alberto Foà Matteo Armillotta Matteo Armillotta Angelo Sansonetti Angelo Sansonetti Sara Amicone Sara Amicone Andrea Impellizzeri Andrea Impellizzeri Giuseppe Esposito Giuseppe Esposito Nuccia Morici Jacopo Andrea Oreglia Gianni Casella Ciro Mauro Dobrin Vassilev Nazzareno Galie Nazzareno Galie Gaetano Santulli Gaetano Santulli Gaetano Santulli Carmine Pizzi Carmine Pizzi Emanuele Barbato Emanuele Barbato Paolo Calabrò Paolo Calabrò Raffaele Marfella Raffaele Marfella In-hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: Insights from the SGLT2-I AMI PROTECT study Frontiers in Cardiovascular Medicine sodium-glucose cotransporter 2 inhibitors (SGLT2-i) acute myocardial infarction atrial fibrillation ventricular arrhythmias ventricular tachycardia hyperglycemia |
| title | In-hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: Insights from the SGLT2-I AMI PROTECT study |
| title_full | In-hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: Insights from the SGLT2-I AMI PROTECT study |
| title_fullStr | In-hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: Insights from the SGLT2-I AMI PROTECT study |
| title_full_unstemmed | In-hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: Insights from the SGLT2-I AMI PROTECT study |
| title_short | In-hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: Insights from the SGLT2-I AMI PROTECT study |
| title_sort | in hospital arrhythmic burden reduction in diabetic patients with acute myocardial infarction treated with sglt2 inhibitors insights from the sglt2 i ami protect study |
| topic | sodium-glucose cotransporter 2 inhibitors (SGLT2-i) acute myocardial infarction atrial fibrillation ventricular arrhythmias ventricular tachycardia hyperglycemia |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1012220/full |
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