# SGLT2-inhibition and myocardial infarction size in patients with type 2 diabetes mellitus– Insights from an acute cardiovascular care center

## TL;DR

This study found that using SGLT2 inhibitors in patients with type 2 diabetes and heart attacks does not reduce heart damage or hospital complications.

## Contribution

The study provides new evidence that ongoing SGLT2 inhibitor use is not associated with reduced myocardial infarction size in T2DM patients.

## Key findings

- SGLT2-i therapy was not associated with reduced myocardial infarction size.
- No significant differences in adverse events or ICU stay were observed between SGLT2-i users and non-users.
- Results were consistent after adjusting for confounding factors using inverse-probability weighted analyses.

## Abstract

This study aimed to assess the association between myocardial infarction (MI) size and clinical outcome with ongoing Sodium-glucose-cotransporter-2 inhibitor (SGLT2-i) use.

In this retrospective single-center cohort study 681 patients with MI and diabetes mellitus type 2 (T2DM) treated with percutaneous coronary intervention (PCI) between November 2015 and December 2023 were included. 105 patients received ongoing SGLT2-i therapy and 576 were taking other glucose-lowering medication at the time of admission. The primary outcome was the size of MI. MI size was determined by the peak high-sensitive troponinT (hs-TnT x ULN [upper limit of normal]) normalized on the endangered myocardial area (EMA). No significant statistical differences were observed in hs-TnT values (hsTnT x ULN: 55 [13–174] vs. 68 [22–182]; p = 0.36) and EMA (41 [29–59] vs. 35 [24–59] %; p = 0.24) between patients with and without SGLT2-i therapy. After augmented inverse-probability weighted analyses, ongoing SGLT2-i therapy was not significantly associated with a reduced MI size (difference between means hsTnT x ULN/EMA [1/%]: − 0.24 [95% confidence interval, − 2.95 to 2.48]; p = 0.54). Secondary outcomes were in-hospital major adverse events and length of intensive care unit (ICU) treatment. SGLT2-i use was not associated with fewer in-hospital adverse events (3.81, vs. 4.17% [95% CI, − 2.95 to 2.48], p = 0.94) or with fewer days on ICU (1 [1–1] vs. 1 [1–2] days, p = 0.78).

In this retrospective cohort study of T2DM patients presenting with MI, prior prescription of SGLT2-i was not associated with reduced MI size or fewer adverse events during hospitalization for MI treated with PCI.

DRKS00032432 (Registration Date: 07 August 2023).

The online version contains supplementary material available at 10.1186/s12872-025-04981-5.