Effect of Dapagliflozin in Type II Diabetic Patients Presenting with Acute Myocardial Infarction and Stage B Heart Failure

Background: Patients with type II diabetes mellitus (T2DM) and acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) are at increased risk of major adverse cardiovascular events (MACE). Sodium-glucose co-transporter 2 (SGLT2) inhibitors like dapagliflozin have demonstrated cardiovascular benefits, yet their early impact post-PCI remains underexplored.Aim: To evaluate the effect of dapagliflozin on 30-day mortality and MACE in T2DM patients with AMI undergoing PCI and classified as stage B heart failure.Patients and Methods: This prospective comparative study enrolled 110 T2DM patients with AMI who underwent successful PCI and were classified as stage B heart failure. Patients were divided into two groups: dapagliflozin group (n=55) and control group (n=55). Baseline demographics, comorbidities, echocardiographic parameters, angiographic findings, and 30-day post-discharge outcomes were assessed and compared.Results: The two groups were matched in age, gender, and comorbidities (p > 0.05), except for a higher prevalence of smoking in the control group. Anterior STEMI was the most common presentation. PCI data showed similar use of single drug-eluting stents (p = 0.6) and LAD as the most affected vessel. Echocardiographic assessments revealed comparable ejection fraction and diastolic dysfunction between groups. At 30-day follow-up, no significant difference was noted in mortality (3.6% vs. 5.5%), recurrent MI (1.8% vs. 1.8%), stroke (1.8% vs. 1.8%), heart failure symptoms (7.3% vs. 14.5%), or admissions due to heart failure (3.6% vs. 7.3%). No dapagliflozin-related adverse events were observed.Conclusion: Although this study did not find a statistically significant reduction in early post-discharge cardiovascular events with dapagliflozin in stage B heart failure patients with type 2 diabetes and acute myocardial infarction, previous research indicates a potentially beneficial trend that may become clearer with larger cohorts and extended follow-up. The growing evidence supporting the cardio-renal benefits of SGLT2 inhibitors warrants further investigation into their early use post-AMI.