TY - JOUR
T1 - Empagliflozin in acute Myocardial Infarction
T2 - the EMMY trial
AU - von Lewinski, Dirk
AU - Kolesnik, Ewald
AU - Tripolt, Norbert J
AU - Pferschy, Peter N
AU - Benedikt, Martin
AU - Wallner, Markus
AU - Alber, Hannes
AU - Berger, Rudolf
AU - Lichtenauer, Michael
AU - Saely, Christoph H
AU - Moertl, Deddo
AU - Auersperg, Pia
AU - Reiter, Christian
AU - Rieder, Thomas
AU - Siller-Matula, Jolanta M
AU - Gager, Gloria M
AU - Hasun, Matthias
AU - Weidinger, Franz
AU - Pieber, Thomas R
AU - Zechner, Peter M
AU - Herrmann, Markus
AU - Zirlik, Andreas
AU - Holman, Rury R
AU - Oulhaj, Abderrahim
AU - Sourij, Harald
N1 - Funding Information:
The study was funded by an unrestricted grant of Boehringer Ingelheim (no. 1245.151). NT-proBNP Elecsys kits were kindly provided by Roche Diagnostics.
Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of European Society of Cardiology.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - BACKGROUND AND AIMS: Sodium-glucose co-transporter 2 inhibition reduces the risk of hospitalisation for heart failure and for death in patients with symptomatic heart failure. However, trials investigating the effects of this drug class in patients following acute myocardial infarction are lacking.METHODS: In this academic, multicentre, double-blind trial, patients (n = 476) with acute myocardial infarction accompanied by a large creatine kinase elevation (>800 U/L) were randomly assigned to empagliflozin 10 mg or matching placebo once-daily within 72 hours of percutaneous coronary intervention. The primary outcome was the N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP) change over 26 weeks. Secondary outcomes included changes in echocardiographic parameters.RESULTS: Baseline median (interquartile range) NT-proBNP was 1,294 (757-2,246) pg/ml. NT-proBNP reduction was significantly greater in the empagliflozin group, compared with placebo, being 15% lower (95% confidence interval [CI] -4.4% to -23.6%) after adjusting for baseline NT-proBNP, sex and diabetes status (p = 0.026). Absolute left ventricular ejection fraction improvement was significantly greater (1.5%, 95% CI 0.2% to 2.9%, p = 0.029), mean E/e' reduction was 6.8% (95% CI 1.3% to 11.3%, p = 0.015) greater, and left ventricular end-systolic and end-diastolic volumes were lower by 7.5 ml (95% CI 3.4 to 11.5 ml, p = 0.0003) and 9.7 ml (95% CI 3.7 to 15.7 ml, p = 0.0015), respectively, in the empagliflozin group, compared with placebo. Seven patients were hospitalised for heart failure (three in the empagliflozin group). Other predefined serious adverse events were rare and did not differ significantly between groups.CONCLUSIONS: In patients with a recent myocardial infarction, empagliflozin was associated with a significantly greater NT-proBNP reduction over 26 weeks, accompanied by a significant improvement in echocardiographic functional and structural parameters.
AB - BACKGROUND AND AIMS: Sodium-glucose co-transporter 2 inhibition reduces the risk of hospitalisation for heart failure and for death in patients with symptomatic heart failure. However, trials investigating the effects of this drug class in patients following acute myocardial infarction are lacking.METHODS: In this academic, multicentre, double-blind trial, patients (n = 476) with acute myocardial infarction accompanied by a large creatine kinase elevation (>800 U/L) were randomly assigned to empagliflozin 10 mg or matching placebo once-daily within 72 hours of percutaneous coronary intervention. The primary outcome was the N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP) change over 26 weeks. Secondary outcomes included changes in echocardiographic parameters.RESULTS: Baseline median (interquartile range) NT-proBNP was 1,294 (757-2,246) pg/ml. NT-proBNP reduction was significantly greater in the empagliflozin group, compared with placebo, being 15% lower (95% confidence interval [CI] -4.4% to -23.6%) after adjusting for baseline NT-proBNP, sex and diabetes status (p = 0.026). Absolute left ventricular ejection fraction improvement was significantly greater (1.5%, 95% CI 0.2% to 2.9%, p = 0.029), mean E/e' reduction was 6.8% (95% CI 1.3% to 11.3%, p = 0.015) greater, and left ventricular end-systolic and end-diastolic volumes were lower by 7.5 ml (95% CI 3.4 to 11.5 ml, p = 0.0003) and 9.7 ml (95% CI 3.7 to 15.7 ml, p = 0.0015), respectively, in the empagliflozin group, compared with placebo. Seven patients were hospitalised for heart failure (three in the empagliflozin group). Other predefined serious adverse events were rare and did not differ significantly between groups.CONCLUSIONS: In patients with a recent myocardial infarction, empagliflozin was associated with a significantly greater NT-proBNP reduction over 26 weeks, accompanied by a significant improvement in echocardiographic functional and structural parameters.
KW - Biomarkers
KW - Heart Failure/drug therapy
KW - Humans
KW - Myocardial Infarction/drug therapy
KW - Natriuretic Peptide, Brain
KW - Peptide Fragments/therapeutic use
KW - Stroke Volume
KW - Ventricular Function, Left
KW - Heart failure
KW - Myocardial infarction
KW - Empagliflozin
KW - NT-proBNP
KW - Randomised controlled trial
KW - Clinical trial
UR - http://www.scopus.com/inward/record.url?scp=85139181942&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehac494
DO - 10.1093/eurheartj/ehac494
M3 - Journal article
C2 - 36036746
SN - 0195-668X
VL - 43
SP - 4421
EP - 4432
JO - European Heart Journal
JF - European Heart Journal
IS - 41
ER -