Naunyn Schmiedebergs Arch Pharmacol. 2026 Mar 10. doi: 10.1007/s00210-026-05198-9. Online ahead of print.
ABSTRACT
Hypertension is a major risk factor for coronary artery disease (CAD) and contributes to a prothrombotic state. Sodium-glucose cotransporter-2 inhibitors (SGLT2is) offer cardiovascular and renal benefits, but their effects on hypertension-related coagulation dysfunction remain unclear. This study assessed whether SGLT2is are associated with coagulation function in hypertensive CAD patients. This retrospective cohort study included 243 CAD patients, divided into four groups based on hypertension and SGLT2i treatment: HTN-SGLT2i (n = 56), HTN-non-SGLT2i (n = 74), non-HTN-SGLT2i (n = 50), and non-HTN-non-SGLT2i (n = 63). Coagulation markers were evaluated at baseline and after 1 month. Two-way repeated measures ANOVAs and Scheirer-Ray-Hare tests were used to assess treatment-time interactions. Among hypertensive patients, SGLT2i use was associated with significant changes in coagulation parameters, including increased antithrombin III (AT-III) (p = 0.032), shortened prothrombin time (PT, p = 0.028), higher prothrombin activity (PTA, p = 0.004), reduced international normalized ratio (INR, p = 0.028), and decreased in D-dimer levels (p = 0.032). No significant changes observed in non-hypertensive patients. Significant interactions for AT-III, D-dimer, PT, PTA, and INR (all p < 0.05) support a hypertension-dependent effect. SGLT2is are associated with changes in coagulation profiles, including enhanced AT-III and reduced D-dimer levels, which may contribute to a lower thrombotic risk. Their lack of effect in normotensive individuals suggests a hypertension-specific mechanism, supporting further investigation into the antithrombotic benefits of SGLT2is in this population.
PMID:41806034 | DOI:10.1007/s00210-026-05198-9