Effects of SGLT2 Inhibitors As an Add-on Therapy to Metformin on Electrocardiographic Indices of Ventricular Repolarization

Overview

Journal Acta Cardiol Sin

Date 2020 Nov 25

PMID 33235419

Citations 11

Authors

Mustafa Duran

Murat Ziyrek

Yakup Alsancak

Affiliations

Soon will be listed here.

Abstract

Background: According to EMPA-REG OUTCOME, trial use of empagliflozin in patients with a history of cardiovascular disease improves hospitalization for heart failure and decreases cardiovascular morbidity and mortality. Recent studies have shown that a prolonged T-peak to T-end interval on the resting electrocardiography is associated with an increased risk of cardiovascular mortality. Tp-e/corrected QT interval (QTc) ratio is a reliable index of prolonged ventricular repolarization.

Objectives: In this study, we examined the effects of sodium glucose co-transporters 2 (SGLT2) inhibitors as an add-on therapy to metformin on electrocardiographic indices of ventricular repolarization.

Methods: Electrocardiographic recordings before combination therapy along with three months and six months follow-up of 141 consecutive patients who were switched from monotherapy to combination therapy with two oral agents due to inadequate glycemic control were derived. QT interval (QT), QTc, Tp-e intervals and Tp-e/QT, Tp-e/QTc ratios were calculated and analyzed.

Results: After the six month follow-up, there was a significant decrease in the QT interval in patients who were using SGLT2 inhibitors as an add-on therapy to metformin compared to other glucose-lowering agents (373.4 ± 9.9 ms vs. 385.4 ± 12.5 ms, 382.9 ± 11.2 ms; p < 0.001 respectively). Furthermore, Tp-e/QT and Tp-e/QTc ratios were significantly lower in this patient population compared to control groups (0.186 ± 0.023 vs. 0.196 ± 0.021, 0.191 ± 0.017; p < 0.001 and 0.174 ± 0.021 vs. 0.199 ± 0.022, 0.195 ± 0.016; p < 0.001 respectively).

Conclusions: Our data showed that using SGLT2 inhibitors as an add-on therapy to metformin favorably alters ventricular repolarization indices in patients with type 2 diabetes mellitus.

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