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. |
