Effects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up

Introduction: Minimally invasive extracorporeal circulation (MiECC) reduced inflammatory burden, leading to best clinical outcomes in patients treated with coronary artery bypass grafting (CABG). Despite this, the patients with type 2 diabetes mellitus (T2DM) vs those without T2DM (non-T2DM) have a...

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Autores principales:	Celestino Sardu, Massimo Massetti, Nicola Testa, Luigi Di Martino, Gaetano Castellano, Fabrizio Turriziani, Ferdinando Carlo Sasso, Michele Torella, Marisa De Feo, Gaetano Santulli, Giuseppe Paolisso, Raffaele Marfella
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	type 2 diabetes mellitus, coronary heart disease coronary artery bypass grafting sodium-glucose transporter 2 inhibitors minimally invasive extracorporeal circulation multi-vessel coronary stenosis over-inflammation Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/f33bf0978d55443e8ab8cb98ecd53960
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spelling	oai:doaj.org-article:f33bf0978d55443e8ab8cb98ecd539602021-11-15T06:56:11ZEffects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up1663-981210.3389/fphar.2021.777083https://doaj.org/article/f33bf0978d55443e8ab8cb98ecd539602021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphar.2021.777083/fullhttps://doaj.org/toc/1663-9812Introduction: Minimally invasive extracorporeal circulation (MiECC) reduced inflammatory burden, leading to best clinical outcomes in patients treated with coronary artery bypass grafting (CABG). Despite this, the patients with type 2 diabetes mellitus (T2DM) vs those without T2DM (non-T2DM) have a worse prognosis, caused by over-inflammation and modulated by sodium-glucose transporter 2 receptors. However, we evaluated the inflammatory burden and clinical outcomes in non-T2DM vs T2DM patients under sodium-glucose transporter 2 inhibitors (SGLT2-I users) vs non-SGLT2-I users at 5 years of follow-up post-CABG via MiECC.Materials and methods: In a multicenter study, we screened consecutive patients with indications to receive CABG. The study endpoints were the inflammatory burden (circulating serum levels of tumor necrosis factor-alpha (TNF-α), interleukin 1 and 6 (IL-1 and IL-6), C-reactive protein (CRP), and leucocytes count) and the clinical outcomes at follow-up of 5 years in non-T2DM vs SGLT2-I users, in non-T2DM vs non-SGLT2-I users, and SGLT2-I users vs non-SGLT2-I users.Results: At baseline, and at one year and 5 years of follow-up, the non-T2DM vs SGLT2-I users, non-T2DM vs non-SGLT2-I users, and SGLT2-I users vs non-SGLT2-I users had the lowest values of IL-1, IL-6, and TNF-α (p < 0.05). At one year of follow-up, SGLT2-I users vs non-T2DM and non-SGLT2-I users vs non-T2DM users had a higher rate of all deaths, cardiac deaths, re-myocardial infarction, repeat revascularization, and stroke, and of the composite endpoint (p < 0.05). In a multivariate Cox regression analysis, the composite endpoint was predicted by IL-1 [2.068 (1.367–3.129)], TNF-α [1.989 (1.081–2.998)], and SGLT2-I [0.504 (0.078–0.861)].Conclusion: In T2DM patients, the SGLT2-I significantly reduced the inflammatory burden and ameliorated clinical outcomes at 5 years of follow-up post-CABG via MiECC.Celestino SarduCelestino SarduMassimo MassettiMassimo MassettiNicola TestaLuigi Di MartinoGaetano CastellanoFabrizio TurrizianiFerdinando Carlo SassoMichele TorellaMarisa De FeoGaetano SantulliGaetano SantulliGaetano SantulliGiuseppe PaolissoGiuseppe PaolissoRaffaele MarfellaRaffaele MarfellaFrontiers Media S.A.articletype 2 diabetes mellitus, coronary heart diseasecoronary artery bypass graftingsodium-glucose transporter 2 inhibitorsminimally invasive extracorporeal circulationmulti-vessel coronary stenosisover-inflammationTherapeutics. PharmacologyRM1-950ENFrontiers in Pharmacology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	type 2 diabetes mellitus, coronary heart disease coronary artery bypass grafting sodium-glucose transporter 2 inhibitors minimally invasive extracorporeal circulation multi-vessel coronary stenosis over-inflammation Therapeutics. Pharmacology RM1-950
spellingShingle	type 2 diabetes mellitus, coronary heart disease coronary artery bypass grafting sodium-glucose transporter 2 inhibitors minimally invasive extracorporeal circulation multi-vessel coronary stenosis over-inflammation Therapeutics. Pharmacology RM1-950 Celestino Sardu Celestino Sardu Massimo Massetti Massimo Massetti Nicola Testa Luigi Di Martino Gaetano Castellano Fabrizio Turriziani Ferdinando Carlo Sasso Michele Torella Marisa De Feo Gaetano Santulli Gaetano Santulli Gaetano Santulli Giuseppe Paolisso Giuseppe Paolisso Raffaele Marfella Raffaele Marfella Effects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up
description	Introduction: Minimally invasive extracorporeal circulation (MiECC) reduced inflammatory burden, leading to best clinical outcomes in patients treated with coronary artery bypass grafting (CABG). Despite this, the patients with type 2 diabetes mellitus (T2DM) vs those without T2DM (non-T2DM) have a worse prognosis, caused by over-inflammation and modulated by sodium-glucose transporter 2 receptors. However, we evaluated the inflammatory burden and clinical outcomes in non-T2DM vs T2DM patients under sodium-glucose transporter 2 inhibitors (SGLT2-I users) vs non-SGLT2-I users at 5 years of follow-up post-CABG via MiECC.Materials and methods: In a multicenter study, we screened consecutive patients with indications to receive CABG. The study endpoints were the inflammatory burden (circulating serum levels of tumor necrosis factor-alpha (TNF-α), interleukin 1 and 6 (IL-1 and IL-6), C-reactive protein (CRP), and leucocytes count) and the clinical outcomes at follow-up of 5 years in non-T2DM vs SGLT2-I users, in non-T2DM vs non-SGLT2-I users, and SGLT2-I users vs non-SGLT2-I users.Results: At baseline, and at one year and 5 years of follow-up, the non-T2DM vs SGLT2-I users, non-T2DM vs non-SGLT2-I users, and SGLT2-I users vs non-SGLT2-I users had the lowest values of IL-1, IL-6, and TNF-α (p < 0.05). At one year of follow-up, SGLT2-I users vs non-T2DM and non-SGLT2-I users vs non-T2DM users had a higher rate of all deaths, cardiac deaths, re-myocardial infarction, repeat revascularization, and stroke, and of the composite endpoint (p < 0.05). In a multivariate Cox regression analysis, the composite endpoint was predicted by IL-1 [2.068 (1.367–3.129)], TNF-α [1.989 (1.081–2.998)], and SGLT2-I [0.504 (0.078–0.861)].Conclusion: In T2DM patients, the SGLT2-I significantly reduced the inflammatory burden and ameliorated clinical outcomes at 5 years of follow-up post-CABG via MiECC.
format	article
author	Celestino Sardu Celestino Sardu Massimo Massetti Massimo Massetti Nicola Testa Luigi Di Martino Gaetano Castellano Fabrizio Turriziani Ferdinando Carlo Sasso Michele Torella Marisa De Feo Gaetano Santulli Gaetano Santulli Gaetano Santulli Giuseppe Paolisso Giuseppe Paolisso Raffaele Marfella Raffaele Marfella
author_facet	Celestino Sardu Celestino Sardu Massimo Massetti Massimo Massetti Nicola Testa Luigi Di Martino Gaetano Castellano Fabrizio Turriziani Ferdinando Carlo Sasso Michele Torella Marisa De Feo Gaetano Santulli Gaetano Santulli Gaetano Santulli Giuseppe Paolisso Giuseppe Paolisso Raffaele Marfella Raffaele Marfella
author_sort	Celestino Sardu
title	Effects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up
title_short	Effects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up
title_full	Effects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up
title_fullStr	Effects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up
title_full_unstemmed	Effects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up
title_sort	effects of sodium-glucose transporter 2 inhibitors (sglt2-i) in patients with ischemic heart disease (ihd) treated by coronary artery bypass grafting via miecc: inflammatory burden, and clinical outcomes at 5 years of follow-up
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/f33bf0978d55443e8ab8cb98ecd53960
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Effects of Sodium-Glucose Transporter 2 Inhibitors (SGLT2-I) in Patients With Ischemic Heart Disease (IHD) Treated by Coronary Artery Bypass Grafting via MiECC: Inflammatory Burden, and Clinical Outcomes at 5 Years of Follow-Up

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