Background: Sodium glucose co-transporter 2 (SGLT2) inhibitors could early reduce cardiovascular (CV) and heart failure (HF) risk in patients with type 2 diabetes mellitus (T2DM) in recent CV outcome trials. We hypothesized that benefit of SGLT2 inhibitors would be early on both hemodynamic and metabolic CV markers.

Objectives: The goal of this study was to examine the effects of empagliflozin or dapagliflozin on CV markers. Factors associated beneficial CV marker changes were determined.

Material and Method: This prospective study included 60 patients with T2DM, In ASCVD group (n = 18), all patients received empagliflozin (n = 18). In non-ASCVD groups (n = 42), they were allocated to received either empagliflozin or dapagliflozin. The study assessed the change in serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), apolipoprotein B (apo B), and highly sensitive C-reactive protein (hsCRP) from baseline to 4, and 26 weeks.

Results: Median change of NT-proBNP from baseline after receiving SGLT2 inhibitors were -11.1 (-30.4, -1.3) pg/mL, and -11.5 (-30.4, -1.5) pg/mL at weeks 4, and 26, respectively (all p <0.05). Although, median change of body weight (BW) were initially -0.77 (-1.11, -0.44) kg and -1.65 (-2.3, -1.01) kg at the end of the study, both apo B and hsCRP were not statistically changed. We found that baseline NT-proBNP >125 pg/mL could predict beneficial in hemodynamic in CV marker changes with sensitivity 58.3%, specificity 96.6%, positive predictive value 87.5%, negative predictive value 84.8% and accuracy 85.4%.

Conclusion: We demonstrated that SGLT2 inhibitors had early beneficial effect in hemodynamic CV marker. Furthermore, SGLT2 inhibitors didn’t have detrimental effect on both atherogenic lipoprotein particle and inflammatory CV markers. Measurement of NT-proBNP level might enhance CV risk stratification and guide introduction of SGLT2 inhibitors in both ASCVD and non-ASCVD patients with T2DM.


N. Sathavarodom: None.

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