SGLT2 Inhibitors Significantly Lower the Cardiac Electrophysiological Balance Index in Type 2 Diabetes Patients

OBJECTIVE
A new oral antidiabetic drug group sodium-glucose cotransporter 2 (SGLT-2) inhibitors have cardioprotective benefits and positive metabolic effects in diabetes mellitus (DM) patients. Cardiac electrophysiological balance Index (ICEB) is a eletrocardiographical ratio giving information about the equilibrium between mainly left ventricular depolarization and repolarization duration and provides valuable information regarding predisposition to ventricular arrhythmias. Aim of this study is to analyze possible impact of SGLT-2 inhibitors on ICEB


METHODS
Patients were selected prospectively from 2789 consecutive type 2 DM patients. After exclusion, 174 patients formed monotherapy group and 143 age and sex matched patients who were switched to SGLT-2 inhibitor combination therapy formed combination therapy group. All treatment changes were supervised by endocrinologists who were blinded to the patient group. Basal and 6th month ECG data of both groups were analyzed. ICEB defined as QT/QRS and ICEBc defined as QTc/QRS.


RESULTS
Although there were no statistical significance between monotherapy and combination therapy groups interms of basal ECG parameters, QT (385.05±13.21 vs. 372.32±4.32; p<0.001), QTc (409.24±8.17 vs. 383.72±7.24; p<0.001), ICEB (4.15±0.51 vs. 4.03±0.54; p=0.004), ICEBc (4.40±0.75 vs. 4.16±0.61; p<0.0001) values at 6th month were significantly lower in SGLT group.


CONCLUSIONS
SGLT-2 inhibitors significantly lower ICEB and ICEBc which would improve ventricular susceptibility to arrhythmias in diabetic patients early as six months into the treatment.