Enhanced therapy for coronary artery disease and diabetes mellitus: impact on biomarkers and clinical outcomes

Background. Cardiovascular diseases like coronary artery disease (CAD) are a major global health issue, causing millions of deaths each year. Type 2 diabetes mellitus (T2DM) worsens outcomes for those with CAD. Common risk factors suggest potential synergistic treatment approaches, including the use of quercetin, a natural flavonoid. The purpose was to examine the clinical efficacy and safety of empagliflozin and quercetin in the treatment of coronary artery disease and type 2 diabetes mellitus comorbidity in the light of their impact on parameters of inflammation. Materials and methods. A total of 128 patients diagnosed with both stable CAD and T2DM were enrolled in the study between January and December 2023. Participants were categorized into three groups. Group 1 (controls): 40 patients receiving the standard treatment protocol for CAD and T2DM. Group 2: 46 patients received standard therapy in addition to empagliflozin (10 mg daily). Group 3: 42 patients received standard therapy in addition to empagliflozin (10 mg daily) and quercetin (80 mg three times a day). Results. The results showed that age and gender were similar between the groups, indicating a balanced distribution. The study then evaluated the effects of treatment on various parameters. The baseline body mass index (BMI), glucose, glycated hemoglobin (HbA1c), soluble suppression of tumorigenicity 2 (sST2), Toll-like receptor 2 (TLR2) and TLR4 levels were comparable across all groups. After treatment, significant reductions were observed in BMI, fasting glucose, HbA1c, sST2, and TLR2/TLR4 in all groups. The most significant improvements were seen in the group that received both empagliflozin and quercetin. The findings highlight the potential benefits of these interventions in patients with coronary heart disease and type 2 diabetes mellitus. Conclusions. The addition of empagliflozin and quercetin to standard therapy appears to offer significant benefits in managing BMI, glycemic control, and inflammatory markers in patients with CAD and T2DM. The combined treatment regimen has potential to address the complex interplay of metabolic and inflammatory processes in high-risk patients. The proposed combination also showed efficacy in reducing the myocardial stress, which is shown by a decrease in serum sST2.