Abstract Body (Do not enter title and authors here): Background:
The beneficial effect of SGLT-2 inhibitors in managing type 2 diabetes mellitus and heart failure with reduced ejection fraction has already been established. However, the outcomes of dapagliflozin on cardiovascular events in patients with acute myocardial infarction are not well studied.

Hypothesis:
Our study aims to investigate the effect of dapagliflozin in reducing cardiovascular events among patients with acute myocardial infarction.

Methods:
A systematic search was conducted using multiple electronic databases from inception until March 2024 using the appropriate Mesh terms, “ dapagliflozin,” “SGLT 2 inhibitors,” “acute myocardial infarction,” “heart failure,” “major cardiovascular events,” “all-cause mortality.” We used the random effect model to calculate the pooled relative risk and their corresponding confidence interval. A p-value of <0.05 was considered statistically significant.

Results:
A meta-analysis was conducted using 5 studies that included 9321 patients (Dapagliflozin: 4404 and Placebo: 4917) with a mean age of 62.46 and 63.26 years respectively. Out of these, four studies included DM with heart failure patients and one study without DM and Heart failure patients. The average follow-up was 21.5 years. Pooled analysis showed that dapagliflozin is associated with a lower risk of acute kidney injury (RR 0.52, 95%CI: 0.12-0.92 p<0.001). However, no statistically significant difference was noticed in reducing all-cause mortality rate (RR 0.73, 95% CI 0.32-1.14, p=0.09), major cardiovascular events (RR, 0.73, 95% CI 0.44-1.02, p=0.27), cardiovascular mortality rate (RR 0.95, 95% CI 0.70-1.20, p=0.54), stroke (RR 0.80, 95% CI 0.50-1.09, p=0.69), and serious adverse events (RR 1.00, 95%CI: 0.88-1.13, p=0.95).

Conclusion:
Dapagliflozin was associated with a lower risk of acute kidney injury. However, the risk of major cardiovascular events, and cardiovascular mortality rate were comparable between both groups of patients.