ESC Congress 2026 Abstract · Oct 26, 2026
Dapagliflozin ameliorates arterial stiffness, endothelial glycocaclyx and myocardial performance in non-diabetic STEMI patients: a 3-month follow-up study
By Thymis J, Georgiopoulos G, Katogiannis K et al.
Background: Sodium glucose Cotransporter-2 inhibitor (SGLT2i) have been recently administered efficiently in the acute phase of Acute Myocardial Infarctions (AMI) in patients without diabetes or heart failure. Purpose: We aimed to address the effects of dapagliflozin in arterial wall elastic properties, thickness of endothelial glycocalyx and myocardial performance in STEMI participants. Methods: We included participants hospitalized in the Cardiology Unit for STEMI without diabetes or heart failure. Patients were commenced on 10 mg dapagliflozin as an add-on to the standard of care treatment upon discharge for the index event. We also entailed a control group of STEMI patients with similar age, sex and risk factors by propensity score matching (1:1 ratio) who received standard of care treatment. We measured at enrollment and at 3 months: a) perfused boundary region (PBR) of the sublingual microvessels with a lumen diameter ranging from 4 to 25 μm, as a marker of endothelial glycocalyx integrity (Sideview Darkfield Imaging); higer PBR values reflect reduced thickness of endothelial glycocalyx layer b) carotid-femoral pulse wave velocity (PWV- Complior SP ALAM), c) systolic blood pressure (SBP) and d) Left Ventricular Global Longitudinal Strain (LV GLS) and by echocardiography, as indicators of myocardial performance. Results: We totally assigned (n=80) participants , aged 56±9 years, 61/80 (76.25%) were males, of which (n=40) received dapagliflozin and (n=40) served as controls. 32/80 (40%) were smokers, 28/80 (35%) had hyperlipidemia and 40/80 (50%) hypertension. The baseline PBR4-25 , PWV, SBP , LV GLS and LVEF did not differ between the two groups (p>0.05). At 3-month follow-up assessment participants in the dapagliflozin arm displayed a greater improvement of PBR4-25, PWV and LVGLS compared to the control group (for PBR4-25: -8.40% vs 7.92% respectively, p=0.010; for PWV: -6.10% vs 12.30% respectively, p=0.004; for LV GLS: 9.90% vs -1.85% respectively, p=0.006) (Table). The percentage change of PWV was associated the percentage change of LV GLS (r=-0.581, p=0.001). No significant differences were observed in the change of SBP and LV EF between the two groups (p>0.05). Conclusion: STEMI patients without diabetes treated with dapagliflozin for 3 months show marked improvement of arterial stiffness, endothelial glycocalyx integrity and myocardial performance.Table