THU345 SGLT2 Inhibitors Reduce Mortality In Patients With Acute Myocardial Infarction And Percutaneous Coronary Intervention: A Systematic Review And Meta-analysis

Disclosure: S.G. Ribeiro: None. P.E. Carvalho: None. A.B. Neto: None. N. Felix: None. L. Teixeira: None. M.M. Gauza: None. M.S. Guisso: None. C.C. Jorge: None. P.M. Camara: None. J.C. Neto: None. A.R. Amaral: None. J.D. Sa: None. Background: The effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on the prognosis of patients with acute myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) is not well established. Objectives: We performed a systematic review and meta-analysis to compare cardiovascular endpoints in patients undergoing PCI after acute MI treated with versus without SGLT2i. Methods: Medline, Cochrane, and Embase were systematically searched for randomized and non-randomized controlled trials that reported cardiovascular outcomes after SGLT2i initiation following PCI in patients with acute MI. Odds ratio (OR) with 95% confidence intervals (CI) were pooled with a random-effects model. Risk of bias assessment was performed as outlined by Cochrane recommendations. Results: There were 6 included studies, with 2,147 patients with acute MI and PCI, of whom 597 (27.8%) received SGLT2i therapy; 1,085 (50.5%) had diabetes mellitus. Two studies were randomized, whereas 4 studies were non-randomized cohorts. Treatment with SGLT2i reduced all-cause mortality (OR 0.49; 95% CI 0.26-0.95; p=0.03; I(2)=0%) and severe arrhythmia (OR 0.31; 95% CI 0.12-0.79; p=0.01; I(2)=0%) compared with no SGLT2i therapy. In contrast, there was no difference between groups in the incidence of myocardial infarction (OR 0.47; 95% CI 20-1.10; p=0.09; I(2)=40%) and repeat revascularizations (OR 0.86; 95% CI 0.34-2.13; I(2)=61%). Conclusion: In this meta-analysis of 2,147 patients with acute MI undergoing PCI, SGLT2i significantly reduced all-cause mortality and severe arrhythmia compared to no SGLT2i therapy. Presentation: Thursday, June 15, 2023