Efficacy and influencing factors analysis of SGLT2 inhibitors in treating heart failure following acute myocardial infarction.

PURPOSE: Heart failure (HF) following acute myocardial infarction (AMI) significantly impacts morbidity and mortality. Sodium-glucose co-transporter 2 (SGLT2) inhibitors, initially developed for type 2 diabetes mellitus, have shown cardiovascular benefits. This study evaluates the efficacy of SGLT2 inhibitors in treating HF post-AMI compared to conventional treatments. METHODS: We conducted a retrospective cohort study at our hospital from September 2022 to September 2024 involving 315 patients with HF post-AMI. Patients were categorized into a conventional treatment group (n = 140) and an SGLT2 inhibitor group (n = 175), with the latter further divided into effective (n = 154) and ineffective (n = 21) subgroups. Cardiac function was assessed pre- and post-treatment using echocardiography and serum biomarkers. Baseline characteristics and potential predictors of SGLT2 efficacy were also analyzed. RESULTS: The SGLT2 group exhibited significant improvements in left ventricular ejection fraction (LVEF), decreased NT-proBNP, troponin I, and hs-CRP levels compared to the conventional group (P < 0.001). The overall effectiveness rate was 88.00% versus 75.71% in the conventional group (P = 0.004). Lower baseline LVEF and higher NT-proBNP levels were significant predictors of better outcomes. Notably, adverse reactions such as angina were reduced in the SGLT2 group. CONCLUSION: SGLT2 inhibitors were associated with enhanced cardiac function and reduce cardiac stress markers in HF patients post-AMI, suggesting their potential as an adjunctive therapy. Lower baseline LVEF and higher NT-proBNP levels may predict better response, suggesting their utility in personalized treatment strategies. This was a retrospective single-center study, and further prospective trials are needed to confirm these findings.