TCT-801 Comparative Efficacy and Safety of Beta Blockers Versus SGLT2 Inhibitors in Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries (MINOCA)
Document Type
Abstract
Publication Date
10-28-2025
Abstract
Background: MINOCA represents a distinct clinical entity of acute myocardial infarction without obstructive coronary artery disease, posing challenges in therapeutic strategies. While beta blockers are commonly prescribed post-MI, the cardiometabolic and endothelial benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2i) offer a novel therapeutic potential in this population. We compared the clinical outcomes of beta blocker therapy versus SGLT2 inhibitor therapy in patients with MINOCA. Methods: This retrospective, multicenter cohort study analyzed 842 patients diagnosed with MINOCA between 2018–2023. Patients were grouped based on discharge medications: beta blockers (BB group, n=416) or SGLT2 inhibitors (SGLT2i group, n=426). The primary endpoint was the composite of cardiovascular death, heart failure hospitalization, or recurrent MI at 12 months. Secondary endpoints included all-cause mortality, stroke, new-onset heart failure, and left ventricular ejection fraction (LVEF) improvement. Propensity score matching was used (1:1), resulting in 342 matched pairs. Results: At 12 months, the primary composite endpoint occurred in 12.6% of the SGLT2i group versus 20.2% of the BB group (p=0.007). SGLT2i were associated with lower rates of heart failure hospitalization (4.1% vs. 9.4%, p=0.003) and greater LVEF improvement (+8.2% vs. +3.5%, p< 0.001). No significant differences were observed in recurrent MI (4.7% vs. 6.1%, p=0.39) or stroke (1.8% vs. 2.3%, p=0.62). All-cause mortality was lower in the SGLT2i group (3.8% vs. 7.3%, p=0.03). Conclusion: In patients with MINOCA, SGLT2 inhibitors were associated with improved cardiovascular outcomes compared to beta blockers, particularly in reducing heart failure-related events and enhancing cardiac function. Categories: CORONARY: Pharmacology/Pharmacotherapy
Publication Title
Journal of the American College of Cardiology
Volume
86
Issue
17 Supplement
First Page
B348
Last Page
B348
Recommended Citation
Cilingiroglu, M., Inanc, I., Iliescu, C., & Marmagkiolis, K. (2025). TCT-801 Comparative Efficacy and Safety of Beta Blockers Versus SGLT2 Inhibitors in Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries (MINOCA). Journal of the American College of Cardiology, 86 (17 Supplement), B348-B348. https://doi.org/https://doi.org/10.1016/j.jacc.2025.09.976
Comments
Transcatheter Cardiovascular Therapeutics held 2025-10-25 to 2025-10-28 in San Francisco, CA