Role of sodium glucose cotransporter-2 (SGLT2) inhibitors in the modulation of QTc interval and ventricular arrhythmia in patients with diabetes mellitus combined with hypertension and coronary artery disease

Background: Patients with diabetes mellitus combined with hypertension and coronary artery disease (DM-HTN-CAD) are prone to QTc interval prolongation and ventricular arrhythmia. Although sodium glucose cotransporter-2 (SGLT2) inhibitors have hypoglycemic and cardioprotective effects, their regulatory effects on relevant indicators in such patients still need to be clarified. Objectives: This study aimed to analyze the impact of SGLT2 inhibitor on QTc interval and ventricular arrhythmia in patients with DM-HTN-CAD. Methods: From January 2023 to January 2025, 150 patients with DM-HTN-CAD were selected in the Hospital. Patients were divided into conventional treatment and SGLT2 inhibitor groups depending on the treatment regimen. The SGLT2 inhibitors group received SGLT2 inhibitor treatment in addition to the conventional treatment group. Compression of the main indicators [including QTc interval, changes in echocardiographic parameters (left and right ventricular diameter, left and right atrial diameter and ejection fraction), blood pressure and glucose indicators] and secondary indicators (including quality of life score, incidence of complications and incidence of adverse reactions) before and after treatment was done among both groups. Results: No differences were observed in the basic characteristics between the two groups (P>0.05). After treatment, all parameters between the two groups illustrated a remarkable discrepancy compared with pre-treatment (P<0.05). In addition, patients in the SGLT2 inhibitors group exhibited lower QTc intervals, left and right atrial diameters, left and right ventricular diameters, systolic blood pressure, diastolic blood pressure and fasting blood glucose levels as compared to the conventional therapy group; The left ventricular ejection fractions, quality of life scores and overall clinical response rates were higher (P<0.05). The complications and adverse reaction incidences were lower in the SGLT2 inhibitors group compared to the conventional treatment group (P<0.05). Conclusion: SGLT2 inhibitors effectively shorten QTc interval, reduce ventricular arrhythmia and cardiovascular risks in DM-HTN-CAD patients and show favorable safety for clinical reference.