Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial-Reference-Cited by-同舟云学术

Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial

Published:2024-05-21 Issue:21 Volume:149 Page:1627-1638
ISSN:0009-7322
Container-title:Circulation
language:en
Short-container-title:Circulation

Author:

Hernandez Adrian F.¹,Udell Jacob A.²^ORCID,Jones W. Schuyler¹^ORCID,Anker Stefan D.³^ORCID,Petrie Mark C.⁴^ORCID,Harrington Josephine¹^ORCID,Mattheus Michaela⁵^ORCID,Seide Svenja⁵,Zwiener Isabella⁵^ORCID,Amir Offer⁶^ORCID,Bahit M. Cecilia⁷^ORCID,Bauersachs Johann⁸^ORCID,Bayes-Genis Antoni⁹¹⁰^ORCID,Chen Yundai¹¹^ORCID,Chopra Vijay K.¹²^ORCID,A. Figtree Gemma¹³^ORCID,Ge Junbo¹⁴,G. Goodman Shaun¹⁵¹⁶^ORCID,Gotcheva Nina¹⁷^ORCID,Goto Shinya¹⁸^ORCID,Gasior Tomasz¹⁹²⁰,Jamal Waheed¹⁹,Januzzi James L.²¹^ORCID,Jeong Myung Ho²²,Lopatin Yuri²³^ORCID,Lopes Renato D.¹^ORCID,Merkely Béla²⁴,Parikh Puja B.²⁵^ORCID,Parkhomenko Alexander²⁶^ORCID,Ponikowski Piotr²⁷^ORCID,Rossello Xavier²⁸^ORCID,Schou Morten²⁹^ORCID,Simic Dragan³⁰^ORCID,Steg Philippe Gabriel³¹^ORCID,Szachniewicz Joanna³²,van der Meer Peter³³^ORCID,Vinereanu Dragos³⁴^ORCID,Zieroth Shelley³⁵,Brueckmann Martina¹⁹³⁶^ORCID,Sumin Mikhail¹⁹^ORCID,Bhatt Deepak L.³⁷^ORCID,Butler Javed³⁸³⁹^ORCID

Affiliation:

1. Duke University Department of Medicine, Division of Cardiology, and Duke Clinical Research Institute, Durham, NC (A.F.H., W.S.J., J.H., R.D.L.).

2. Women’s College Hospital and Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Canada (J.A.U.).

3. Department of Cardiology (CVK) of German Heart Center Charité, Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany (S.D.A.).

4. School of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, UK (M.C.P.).

5. Boehringer Ingelheim Pharma GmbH & Co KG, Ingelheim, Germany (M.M., S.S., I.Z.).

6. Heart Institute, Hadassah Medical Center, The Hebrew University of Jerusalem, Israel (O.A.).

7. INECO Neurociencias Oroño, Fundación INECO, Rosario, Santa Fe, Argentina (M.C.B.).

8. Department of Cardiology and Angiology, Hannover Medical School, Germany (J. Bauersachs).

9. Heart Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain (A.B.-G.).

10. Department of Medicine, Universitat Autònomoa de Barcelona, Spain (A.B.-G.).

11. Department of Cardiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China (Y.C.).

12. Max Super Speciality Hospital, Saket, New Delhi, India (V.K.C.).

13. Faculty of Medicine and Health, University of Sydney, Australia (G.A.F.).

14. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China (J.G.).

15. Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (S.G.G.).

16. Division of Cardiology, Department of Medicine, St Michael’s Hospital, Unity Health Toronto and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Canada (S.G.G.).

17. Department of Cardiology, MHAT “National Cardiology Hospital” EAD, Sofia, Bulgaria (N.G.).

18. Department of Medicine (Cardiology), Tokai University School of Medicine, Isehara, Japan (S.G.).

19. Boehringer Ingelheim International GmbH, Ingelheim, Germany (T.G., W.J., M.B., M. Sumin).

20. Collegium Medicum, Faculty of Medicine, WSB University, Dabrowa Gornicza, Poland (T.G.).

21. Division of Cardiology, Harvard Medical School and Massachusetts General Hospital, Boston (J.L.J.).

22. Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea (M.H.J.).

23. Volgograd State Medical University, Russia (Y.L.).

24. Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.).

25. Division of Cardiovascular Medicine, Department of Medicine, State University of New York at Stony Brook (P.B.P.).

26. The Ukrainian Institute of Cardiology na MD Strazhesko, AMS Ukraine, Kyiv (A.P.).

27. Institute of Heart Diseases, Wroclaw Medical University, Poland (P.P.).

28. Hospital Universitari Son Espases, Health Research Institute of the Balearic Islands, University of the Balearic Islands, Palma de Mallorca, Spain (X.R.).

29. Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark (M. Schou).

30. Department of Cardiovascular Diseases, University Clinical Center Belgrade, Serbia (D.S.).

31. Université Paris-Cité, FACT (French Alliance for Cardiovascular Trials), INSERM U-1148, AP-HP, Hôpital Bichat, Paris, France (P.G.S.).

32. Jan Mikulicz–Radecki University Clinical Hospital, Wroclaw, Poland (J.S.).

33. Department of Cardiology, University of Groningen, University Medical Centre Groningen, the Netherlands (P.v.d.M.).

34. University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania (D.V.).

35. Section of Cardiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada (S.Z.).

36. First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany (M.B.).

37. Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY (D.L.B.).

38. Baylor Scott and White Research Institute, Dallas, TX (J. Butler).

39. Department of Medicine, University of Mississippi, Jackson (J. Butler).

Abstract

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.

Funder

Boehringer Ingelheim and Eli Lilly and Company

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference13 articles.

1. Acute Decompensated Heart Failure in the Setting of Acute Coronary Syndrome

2. Incidence, Temporal Trends, and Prognostic Impact of Heart Failure Complicating Acute Myocardial Infarction

3. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

4. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

5. Empagliflozin in acute myocardial infarction: the EMMY trial

Cited by 10 articles. 订阅此论文施引文献订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献

1. Empagliflozin: Primus Inter Pares Among Sodium–Glucose Cotransporter-2 Inhibitors?;Journal of Cardiovascular Pharmacology;2024-09

2. Empagliflozin in Acute Myocardial Infarction Reduces No-Reflow and Preserves Cardiac Function by Preventing Endothelial Damage;JACC: Basic to Translational Science;2024-08

3. Update on evidence-based clinical application of sodium-glucose cotransporter inhibitors: Insight to uncommon cardiovascular disease scenarios in diabetes;World Journal of Diabetes;2024-07-15

4. Endothelial Protection by Sodium-Glucose Cotransporter 2 Inhibitors: A Literature Review of In Vitro and In Vivo Studies;International Journal of Molecular Sciences;2024-07-02

5. Where Are We With Treatment and Prevention of Heart Failure in Patients Post–Myocardial Infarction?;JACC: Heart Failure;2024-07