Myocardial Infarction is a major cause of morbidity and mortality due to the frequent occurrence of acute left ventricular (LV) dysfunction that severely complicates prognosis. The conventional treatment, such as nitrates, beta blockers, ACE inhibitors, statins, antiplatelets and anticoagulants, is symptomatic and reduces the possibility of recurrence but does not completely solve the problem of LV dysfunction development. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have become a potential novel therapeutic agent outside of glucose-lowering activity in recent years. These agents induce natriuresis, osmotic diuresis, positive myocardial energetics and hemodynamic stabilization, which may lower preload, afterload and maladaptive LV remodelling. The literature support shows that dapagliflozin and empagliflozin, the SGLT2 inhibitors, reduce hospitalization due to heart failure as well as diastolic performance and LV mass index and decrease major adverse cardiovascular events (MACE) in diabetic and nondiabetic patients. There are also cardioprotective effects such as smaller infarct size, mitigated LV remodelling and greater ejection fraction as seen in studies with post-MI patients. This review shows that SGLT2 inhibitors might be beneficial as an adjunctive treatment in acute MI with LV dysfunction because they have a potent effect on both short and long-term outcomes. Additional expansive clinical research should be designed to determine therapeutic effect on this population.
K. Abisha Judie*, M. Vigneswari, U. Polireddy, V. E. Dhandapani, S. Sarumathy.