Effect of Empagliflozin on Heart Failure Outcomes after Acute Myocardial Infarction : Insights from the EMPACT-MI Trial
Hernandez, Adrian F. (Duke University Department of Medicine)
Udell, Jacob (University of Toronto)
Jones, W. Schuyler (Duke University Department of Medicine)
Anker, Stefan (Charité-Universitätsmedizin Berlin)
Petrie, Mark (University of Glasgow)
Harrington, Josephine (Duke University Department of Medicine)
Mattheus, Michaela (Boehringer Ingelheim Pharma GmbH & Co KG)
Seide, Svenja (Boehringer Ingelheim Pharma GmbH & Co KG)
Zwiener, Isabella (Boehringer Ingelheim Pharma GmbH & Co KG)
Amir, Offer (The Hebrew University of Jerusalem)
Bahit, Maria Cecilia (Fundación INECO)
Bauersachs, Johann (Hannover Medical School)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Chen, Yundai (The First Medical Center of Chinese PLA General Hospital)
Chopra, Vijay (Max Super Speciality Hospital)
Figtree, Gemma (University of Sydney)
Ge, Junbo (Fudan University)
Goodman, Shaun (University of Toronto)
Gotcheva, Nina (MHAT "National Cardiology Hospital")
Goto, Shinya (Tokai University School of Medicine)
Gasior, Tomasz (WSB University, Dabrowa Gornicza)
Jamal, Waheed (Boehringer Ingelheim International GmbH)
Januzzi, James (Harvard Medical School and Massachusetts General Hospital)
Jeong, Myung Ho (Chonnam National University Hospital and Medical School)
Lopatin, Yuri (Volgograd State Medical University)
Lopes, Renato D. (Duke University Department of Medicine)
Merkely, Bela (Semmelweis University)
Parikh, Puja (State University of New York at Stony Brook)
Parkhomenko, Alexander (The Ukrainian Institute of Cardiology na MD Strazhesko)
Ponikowski, Piotr (Wroclaw Medical University)
Rossello, Xavier (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Schou, Morten (Herlev and Gentofte University Hospital)
Simic, Dragan (University Clinical Center Belgrade)
Steg, Philippe Gabriel (Université Paris-Cité, FACT (French Alliance for Cardiovascular Trials))
Szachniewicz, Joanna (Jan Mikulicz-Radecki University Clinical Hospital)
van der Meer, Peter (University of Groningen)
Vinereanu, Dragos (University and Emergency Hospital)
Zieroth, Shelley (University of Manitoba)
Brueckmann, Martina (University of Heidelberg)
Sumin, Mikhail (Boehringer Ingelheim International GmbH)
Bhatt, Deepak L. (Mount Sinai Fuster Heart Hospital)
Butler, Javed (University of Mississippi (Estats Units d'Amèrica))
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2024
Resum:	BACKGROUND: Empagliflozin reduces the risk of heart failure (HF) events in patients with type 2 diabetes at high cardiovascular risk, chronic kidney disease, or prevalent HF irrespective of ejection fraction. Whereas the EMPACT-MI trial (Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients With Acute Myocardial Infarction) showed that empagliflozin does not reduce the risk of the composite of hospitalization for HF and all-cause death, the effect of empagliflozin on first and recurrent HF events after myocardial infarction is unknown. METHODS: EMPACT-MI was a double-blind, randomized, placebo-controlled, event-driven trial that randomized 6522 patients hospitalized for acute myocardial infarction at risk for HF on the basis of newly developed left ventricular ejection fraction of <45% or signs or symptoms of congestion to receive empagliflozin 10 mg daily or placebo within 14 days of admission. In prespecified secondary analyses, treatment groups were analyzed for HF outcomes. RESULTS: Over a median follow-up of 17. 9 months, the risk for first HF hospitalization and total HF hospitalizations was significantly lower in the empagliflozin compared with the placebo group (118 [3. 6%] versus 153 [4. 7%] patients with events; hazard ratio, 0. 77 [95% CI, 0. 60, 0. 98]; P=0. 031, for first HF hospitalization; 148 versus 207 events; rate ratio, 0. 67 [95% CI, 0. 51, 0. 89]; P=0. 006, for total HF hospitalizations). Subgroup analysis showed consistency of empagliflozin benefit across clinically relevant patient subgroups for first and total HF hospitalizations. The need for new use of diuretics, renin-Angiotensin modulators, or mineralocorticoid receptor antagonists after discharge was less in patients randomized to empagliflozin versus placebo (all P<0. 05). CONCLUSIONS: Empagliflozin reduced the risk of HF in patients with left ventricular dysfunction or congestion after acute myocardial infarction. REGISTRATION: URL: https://www. clinicaltrials. gov; Unique identifier: NCT04509674.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Heart failure ; Hospitalization ; Myocardial infarction
Publicat a:	Circulation, Vol. 149 Núm. 21 (21 2024) , p. 1627-1638, ISSN 1524-4539

DOI: 10.1161/CIRCULATIONAHA.124.069217
PMID: 38581389

12 p, 2.2 MB

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