EMPA-HEART: Empagliflozin Reversed LV Remodeling in T2D Patients

Empagliflozin, an SGLT2 inhibitor, significantly reversed left ventricular (LV) remodeling in a population of diabetic patients with coronary artery disease, new study results presented at the American Heart Association 2018 Scientific Sessions  in Chicago.

Researchers for evaluating the impact of SGLT2 inhibition with empagliflozin in LV remodeling included a total of 152 individuals with type 2 diabetes and a prior history of MI or coronary revascularization in the study. Participants were randomized (1:1) to receive either empagliflozin 10 mg or placebo for six months. The primary endpoints included changes in indexed LV end-systolic/diastolic volumes, LV ejection fraction, regional LV systolic/diastolic function, NT-proBNP, and troponins.

The results suggested that empagliflozin lowered ambulatory blood pressure (P=0.003), increased hematocrit (P=0.006), reduced LV mass (P=0.01). Secondary outcomes, including biomarker levels, were unaffected by empagliflozin therapy. Adverse events were similar between groups.

“These data suggest that the SGLT2i, empagliflozin, promotes early, statistically and clinically significant reverse remodeling which may contribute to the CV and HF benefits observed in the EMPA-REG OUTCOME trial and other SGLT2i studies,” Subodh Verma, MD, of the University of Toronto in Ontario, concluded in a slide presentation.

The added in their conclusion in the study abstract that “EMPA-HEART is the first RCT to evaluate the effect of an SGLT2i on LV structure and function using cMRI in people with type 2 diabetes,” and that the results “provide critical translational and mechanistic clues to explain the benefits of empagliflozin on heart failure and CV death.”

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