Acute myocardial infarction (AMI) is a prevalent and severe cardiovascular disease characterized by its sudden onset, high mortality rate, and poor prognosis. The presence of type 2 diabetes increases the risk for cardiovascular and cerebrovascular diseases such as coronary heart disease and stroke. In Xining, a region with middle to high altitude, the diagnosis of AMI is often delayed due to factors like geographical challenges, limited health awareness, and varying medical standards. This study investigates the effectiveness and prognosis of dapagliflozin in patients with AMI complicated by type 2 diabetes in the Xining region.
A retrospective cohort study was conducted on 245 patients with AMI and type 2 diabetes who were treated at the cardiovascular internal medicine department of Qinghai Province People's Hospital between January 1, 2018, and January 1, 2020. Patients were divided into two groups based on whether they received dapagliflozin during hospitalization: the dapagliflozin group and the control group. Basic demographic information, laboratory test results, and long-term prognosis data were collected. Follow-up continued until December 31, 2023, to evaluate both primary and secondary endpoints.
The study included 245 patients, aged 34 to 94 years, with a mean age of 61 ± 11 years. Of these, 200 patients (81.63%) were male and 45 (18.37%) were female. In the dapagliflozin group, 92 patients (77.97%) were male, while in the control group, 108 patients (85.04%) were male. There were no significant differences between the two groups in terms of age, gender, duration of diabetes, comorbidities, echocardiogram results, or blood biochemical markers (P > 0.05). The two groups also had similar coronary artery lesion counts, treatment regimens, and use of cardiovascular and hypoglycemic drugs (P > 0.05). However, post-discharge, the dapagliflozin group had a significantly lower incidence of cardiovascular adverse events. Specifically, the dapagliflozin group experienced 4 cases of heart failure and 1 case of cardiovascular death, while the control group had 13 cases of heart failure, 10 cardiovascular deaths, and 2 deaths from cerebral hemorrhage. Kaplan-Meier survival analysis showed that the primary endpoint of survival was significantly better in the dapagliflozin group (P < 0.05). Furthermore, the overall survival rate was significantly higher in the dapagliflozin group (P < 0.05).
The findings suggest that dapagliflozin is a safe and effective treatment for patients with AMI and type 2 diabetes. It significantly reduces the incidence of cardiovascular events and improves overall survival rates in these patients.