Correlation Between Glucose Abnormalities Induced By Statins And The Application Of SGLT2 Inhibitors In Non-diabetic Patients With Heart Failure

Objective:This study is conducted to investigate whether the application of SGLT2 inhibitors can reduce the risk of statin-induced glucose abnormalities in non-diabetic patients with heart failure combined with coronary artery disease and to explore the risk factors associated with causing glucose abnormalities by logistic regression analysis.Methods:The study is a single-center prospective cohort study.Non-diabetic patients with heart failure combined with coronary atherosclerotic heart disease diagnosed at the Affiliated Hospital of Qingdao University from 2021.10 to 2022.10 are selected.They are divided into control and SGLT2 inhibitor groups according to whether they are taking SGLT2 inhibitors or not.All patients enrolled in the groups are given statins and conventional heart failure treatment.5 or 10 mg SGLT2 inhibitors are given on top of this treatment in the SGLT2 inhibitor group.Patients in the SGLT2 inhibitor group discontinue SGLT2 inhibitors after they show significant improvement in heart failure symptoms.At the end of follow-up,whether there is a difference in the incidence of glucose abnormalities between the two groups is compared.And the risk factors associated with causing glucose abnormalities are further explored by logistic regression analysis.Results:A total of 1371 patients are included in the study,including 1027 and 344 patients in the control and SGLT2 inhibitor groups,respectively.The mean duration of statin use is 72 and 70 months in the control and SGLT2 inhibitor groups,respectively.There is no statistical difference between the mean statin dosing durations.The average age of the control group is 59 years.In the control group,there are 738 males and 289 females with 62.90%hypertension,42.26%history of smoking and 37.10%history of alcohol consumption.The mean age of SGLT2 inhibitor group is 60 years.In the SGLT2 inhibitor group,there are 246 males and 98 females with 61.63%hypertension,37.5%history of smoking and 37.5%history of alcohol consumption.Between the two groups,no statistical differences are seen between history of smoking,history of alcohol consumption,history of hypertension,age,sex,medication,BMI,FPG,HbAlc,TC,TG,LDL-C,ALT,UA,eGFR,NT-proBNP and LVEF.In the control group,26(2.5%)of the 1027 patients develope glucose abnormalities.Of these,15 are elevated fasting glucose,5 are elevated glycated hemoglobin,3 are elevated both fasting glucose and glycated hemoglobin,and 3 are diabetic.In the SGLT2 inhibitor group,2(0.6%)of the 344 patients develope glucose abnormalities.One of these is elevated fasting glucose and one is elevated glycated hemoglobin.Between the two groups,the difference in the incidence of abnormal blood glucose is statistically significant(P<0.05).The OR is 0.23(95%CI:0.05-0.95),which suggests that SGLT2 inhibitor application can reduce the risk of statin-induced glucose abnormalities in non-diabetic patients with heart failure combined with coronary artery disease.We found that the duration of statin medication is an independent risk factor for the occurrence of glucose abnormalities by logistic regression analysis.As the duration of statin application increases,the incidence of glucose abnormalities increases.What’s more,we found that the application of SGLT2 inhibitors does not increase the cardiac renal and hepatic burden of patients.Conclusion:This study finds that the duration of statin application is an independent risk factor for the occurrence of glucose abnormalities.As the duration of statin application increases,the incidence of glucose abnormalities increases.In non-diabetic patients with heart failure combined with coronary artery disease,the application of SGLT2 inhibitors can reduce the risk of statin-induced glucose abnormalities.And we find that the application of SGLT2 inhibitors does not increase the cardiac renal and hepatic burden of patients.