Document Type : Original Article
Authors
1
Assistant professor of Cardiology, Faculty of Medicine, Benha University, Benha, Egypt
2
MSc Cardiology, Faculty of Medicine, Benha University, Benha, Egypt
3
Professor of Cardiology, Faculty of Medicine, Benha University, Benha, Egypt
4
Lecturer of Cardiology, Faculty of Medicine, Benha University, Benha, Egypt
Abstract
Background: Acute STEMI presents a range of risks for recurrent myocardial infarction, chronic heart failure, and cardiovascular death. Early post-infarction treatment strategies aim to reduce adverse cardiac remodeling and prevent long-term complications like chronic HF and sudden cardiac death. SGLT2 inhibitors, such as Dapagliflozin, have shown potential in modulating ventricular remodeling, suggesting benefits in post-MI management. Aim: This study aimed to evaluate the effects of adding Dapagliflozin to standard post-MI care on morbidity and mortality in patients with acute STEMI and preserved LV systolic function, regardless of diabetic status. Subjects and Methods: Three hundred patients with acute STEMI were randomized into two groups (Group I and II, 150 each). Group I received Dapagliflozin 10 mg orally once, followed by a daily dose of 10 mg, in addition to standard post-MI therapies. Comprehensive assessments, including medical history, clinical examination, electrocardiogram, and echocardiography, were conducted for all participants. Results: The average age of participants was 54 ± 11 years, with 59% male. A significant proportion had diabetes (42%) and hypertension (46%), and 50% were smokers. Group I showed significantly lower rates of recurrent AMI (2% = vs. 12%, P < 0.001), heart failure hospitalizations (4% vs. 14%, P = 0.002), and major adverse cardiac events (6% vs. 27.3%, P < 0.001). However, there were no significant differences in mortality (P = 0.498) or stroke (P = 0.498). Conclusion: Early addition of Dapagliflozin to standard post-STEMI care significantly reduced heart failure hospitalizations and MACE but had no impact on mortality or stroke outcomes.
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