Effects of SGLT2 Inhibition on Metabolic Parameters and Cardiac Function in Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease

Abstract

Objective: To investigate the efficacy and safety of SGLT2 inhibitors in patients with type 2 diabetes mellitus complicated by coronary atherosclerotic heart disease.

Methods: Seventy-six patients diagnosed with coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM) were included in this study conducted at the Department of Cardiology, First Affiliated Hospital of Kunming Medical University, between January 2022 and August 2023. The patients were stratified into two cohorts based on their treatment regimen, the observation group (n=40) and the control group (n=36). The control group received alternative glucose-lowering medications, excluding dapagliflozin, while the observation group was administered dapagliflozin either as monotherapy or in combination with other glucose-lowering agents. Both groups underwent standard secondary prevention therapy for CHD for a duration of 6 months. Comparisons were made between the two groups in terms of TC, TG, LDL-C, HDL-C, FBG, HbA1c, SUA, CRP, BNP, BMI, BW, LVEDD, LVEF, IVST and safety evaluation.

Results: The findings revealed that in the observation group, there were significant reductions in FBG, HbA1c, BMI, BW, SUA, CRP, LDL-C, TC, TG, BNP, LVEDD, and IVST post-treatment compared to pre-treatment levels. Additionally, HDL-C and LVEF exhibited significant increases. While there were no statistically significant differences in LVEDD within the cohort (P > .05), all other intra-group comparisons displayed statistically significant variances (P < .05). Following treatment, the control group exhibited reductions in FBG, HbA1c, BMI, BW, LDL, TC, TG, BNP, LVEDD, and LVEF compared to baseline levels, while HDL, SUA, CRP, and IVST increased. However, these intragroup differences did not reach statistical significance (P > .05). Intergroup analysis following treatment showed statistically significant differences in FBG, HbA1c, CRP, LDL-c, TC, TG, LVEF, and IVST (P < .05). Conversely, no significant intergroup differences were found SUA, BW, BMI, HDL-C, LVEF, LVEDD and BNP (P > 0.05).

Conclusion: dapagliflozin provides cardiovascular benefits by reducing inflammatory responses and improving cardiovascular risk factors through multiple pathways, including lowering blood glucose, regulating blood lipids, reducing inflammatory markers, and inhibiting ventricular remodeling.