Empagliflozin in patients post myocardial infarction rationale and design of the EMPACT-MI trial

Harrington, J. et al. (2022) Empagliflozin in patients post myocardial infarction rationale and design of the EMPACT-MI trial. American Heart Journal, 253, pp. 86-98. (doi: 10.1016/j.ahj.2022.05.010) (PMID:35595091)

Abstract

Background : Patients with acute myocardial infarction (MI) are at risk for developing heart failure (HF) and subsequently are at an increased risk of mortality. Sodium-glucose cotransporter-2 inhibitors have been proven to improve outcomes in patients with HF with reduced ejection fraction, and, in the case of empagliflozin, in HF with preserved ejection fraction even without diabetes, but their efficacy and safety in the post-MI population has not yet been evaluated. Methods : The EMPACT-MI trial will evaluate the safety and efficacy of empagliflozin compared with placebo in patients hospitalized for MI with or at high risk of new onset HF, in addition to standard care. EMPACT-MI is a streamlined, multinational, randomized, double-blind, placebo-controlled trial randomizing 5,000 participants at approximately 480 centers in 22 countries. Eligible patients presenting with spontaneous MI must have new signs or symptoms of pulmonary congestion requiring treatment or new left ventricular dysfunction (LVEF<45%), and at least one additional risk factor for development of future HF. Eligible and consenting patients are randomized to empagliflozin 10mg or placebo daily in addition to standard of care within 14 days of hospital admission for MI. The primary composite endpoint is time to first hospitalization for HF or all-cause mortality. Conclusions : EMPACT-MI will inform clinical practice regarding the role of empagliflozin in patients after an MI with high risk for the development of future HF and mortality.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Petrie, Professor Mark
• Authors: Harrington, J., Udell, J. A., Jones, W. S., Anker, S. D., Bhatt, D. L., Petrie, M. C., Vedin, O., Sumin, M., Zwiener, I., Hernandez, A. F., and Butler, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: American Heart Journal
• Publisher: Elsevier
• ISSN: 0002-8703
• ISSN (Online): 1097-6744
• Published Online: 17 May 2022
• Copyright Holders: Copyright © 2022 The Author(s)
• First Published: First published in American Heart Journal 253: 86-98
• Publisher Policy: Reproduced under a Creative Commons License