Sodium Glucose Cotransporter-2 Inhibition for Acute Myocardial Infarction: JACC Review Topic of the Week

J Am Coll Cardiol. 2022 May 24;79(20):2058-2068. doi: 10.1016/j.jacc.2022.03.353.

Abstract

Sodium glucose cotransporter-2 (SGLT2) inhibitors improve cardiorenal outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and chronic heart failure. SGLT2 inhibitors also reduce the risk of cardiovascular mortality and hospitalization for heart failure among patients with type 2 diabetes mellitus and a remote history of myocardial infarction (MI). As a result of the growing body of evidence in diverse disease states, and the hypothesized mechanisms of action, it is reasonable to consider the potential of SGLT2 inhibition to improve outcomes in patients with acute MI as well if initiated early after presentation. Whether these therapies are efficacious and safe to use early in the course of acute coronary heart disease remains relatively unexplored. Here, we describe the contemporary data and continuing evidence gap for considering the use of SGLT2 inhibitors early following an acute MI to reduce cardiovascular morbidity and mortality.

Keywords: SGLT2; cardioprotection; clinical trials; heart failure; myocardial infarction.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Heart Failure* / chemically induced
  • Heart Failure* / drug therapy
  • Humans
  • Myocardial Infarction* / chemically induced
  • Myocardial Infarction* / drug therapy
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects

Substances

  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors