Related Links
Statistics
| Number of Journals | 8 |
| Number of Issues | 52 |
| Number of Articles | 379 |
| Article View | 107,119 |
| PDF Download | 71,333 |
Evaluating the limited impact of therapy with empagliflozin on primary PCI patients' outcomes: the ELITE-PCI trial | ||
| Cardiovascular Biomedicine | ||
| Volume 5, Issue 1, September 2025, Pages 52-60 PDF (796.1 K) | ||
| Document Type: original articles | ||
| DOI: 10.18502/cbj.v5i1.19452 | ||
| Authors | ||
| Abbas Andishmand; Seyed Mostafa Seyed Hossaini Tezerjani; Hasan Haghaninejad; Sara Amel Shahbaz* ; Seyed Mostafa Mousavi Nodoushan | ||
| 1. Yazd Cardiovascular Research Center, Non- communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| Abstract | ||
| Objectives: Empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, has demonstrated cardiovascular benefits in various patient groups. However, its effects on patients undergoing primary percutaneous coronary intervention (PCI) have not been extensively studied. This research aims to assess the impact of empagliflozin on clinical outcomes for participants in the ELITE-PCI trial. Methods: The ELITE-PCI trial was a prospective, single-center, randomized, triple-blind, placebo-controlled study conducted from June 8, 2023, to May 25, 2024. It included 110 patients with acute myocardial infarction (AMI) undergoing primary PCI, who were assigned to receive either 10 mg of empagliflozin or a placebo. Clinical outcomes, including major adverse cardiovascular events (MACE) and rehospitalization rates, were assessed at 12 weeks post-intervention. Results: The study included 110 participants, with 55 in each group. The mean age was 59.9 years (±10.7) for the empagliflozin group and 58.1 years (±11.9) for the placebo group (p = 0.392). Both groups had a consistent sex distribution (90.9% male, p > 0.999). Baseline characteristics, including BMI, GFR, blood pressure, and left ventricular ejection fraction, showed no significant differences. Diabetes prevalence was 47.3% in the empagliflozin group and 43.6% in the placebo group (p = 0.702). At 12 weeks, MACE was absent, while the empagliflozin group had a 7.2% readmission rate, primarily due to pulmonary edema, compared to 5.4% in the placebo group(p=0.405). Conclusions: The findings of the ELITE-PCI trial suggest that short-term empagliflozin therapy does not have a significant impact on clinical outcomes in patients undergoing primary PCI. Nevertheless, these results highlight the necessity for further research to clarify the role of SGLT2 inhibitors within this patient population. | ||
| Keywords | ||
| Acute myocardial infarction; cardiovascular outcomes; ELITE-PCI trial; empagliflozin; primary PCI | ||
| References | ||
|
1.Sachdeva P, Kaur K, Fatima S, et al. Advancements in Myocardial Infarction Management: Exploring Novel Approaches and Strategies. Cureus. 2023;15(9): e45578.
2.Fatima A, Rasool S, Devi S, et al. Exploring the Cardiovascular Benefits of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors: Expanding Horizons Beyond Diabetes Management. Cureus. 2023;15(9):e46243.
3.Singh R, Chandi SK, Sran S, et al. Emerging Therapeutic Strategies in Cardiovascular Diseases. Cureus. 2024;16(7): e64388.
4.Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-28.
5.Neal B, Perkovic V, Matthews DR. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377(21):2099.
6.Bami K, Gandhi S, Leong-Poi H, et al. Effects of Empagliflozin on Left Ventricular Remodeling in Patients with Type 2 Diabetes and Coronary Artery Disease: Echocardiographic Substudy of the EMPA-HEART CardioLink-6 Randomized Clinical Trial. J Am Soc Echocardiogr. 2020;33(5):644-646.
7.Talha KM, Anker SD, Butler J. SGLT-2 Inhibitors in Heart Failure: A Review of Current Evidence. Int J Heart Fail. 2023; 5(2):82-90.
8.Seferović PM, Coats AJS, Ponikowski P, et al. European Society of Cardiology/Heart Failure Association position paper on the role and safety of new glucose-lowering drugs in patients with heart failure. Eur J Heart Fail. 2020;22(2):196-213.
9.Hasan I, Rashid T, Jaikaransingh V, et al. SGLT2 inhibitors: Beyond glycemic control. J Clin Transl Endocrinol. 2024;35: 100335.
10.Pistelli L, Parisi F, Correale M, et al. Gliflozins: From Antidiabetic Drugs to Cornerstone in Heart Failure Therapy-A Boost to Their Utilization and Multidisciplinary Approach in the Management of Heart Failure. J Clin Med. 2023;12 (1): 379.
11.Von Lewinski D, Kolesnik E, Tripolt NJ, et al. Empagliflozin in acute myocardial infarction: the EMMY trial. Eur Heart J. 2022;43(41):4421-4432.
12.Hernandez AF, Udell JA, Jones WS, et al. Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial. Circulation. 2024;149(21):1627-1638.
13.Butler J, Jones WS, Udell JA, et al. Empagliflozin after Acute Myocardial Infarction. N Engl J Med. 2024;390(16):1455-1466.
14.Benedikt M, Kolesnik E, Sourij H, et al. SGLT2 Inhibition in Acute Myocardial Infarction Comprehensive Review. Rev Cardiovasc Med. 2023;24(2):32.
15.Sachdeva P, Kaur K, Fatima S, et al. Advancements in Myocardial Infarction Management: Exploring Novel Approaches and Strategies. Cureus. 2023;15(9): e45578.
16.Hwang J, Lee K. Mortality and Discharge Outcome in Acute Myocardial Infarction Patients: A Study Based on Korean National Hospital Discharge In-Depth Injury Survey Data. Risk Manag Healthc Policy. 2024; 17:2045-2053.
17.Stone GW, Selker HP, Thiele H, et al. Relationship Between Infarct Size and Outcomes Following Primary PCI: Patient-Level Analysis From 10 Randomized Trials. J Am Coll Cardiol. 2016;67(14):1674-83.
18.Kosmidou I, Redfors B, Selker HP, et al. Infarct size, left ventricular function, and prognosis in women compared to men after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction: results from an individual patient-level pooled analysis of 10 randomized trials. Eur Heart J. 2017;38(21):1656-1663.
19.Selker HP, Udelson JE, Ruthazer R, et al. Relationship between therapeutic effects on infarct size in acute myocardial infarction and therapeutic effects on 1-year outcomes: A patient-level analysis of randomized clinical trials. Am Heart J. 2017; 188:18-25.
20.James S, Erlinge D, Storey RF, et al. Dapagliflozin in Myocardial Infarction without Diabetes or Heart Failure. NEJM Evid. 2024;3(2): EVIDoa2300286.
21.Silverio A, Cancro FP, Esposito L, et al. Secondary Cardiovascular Prevention after Acute Coronary Syndrome: Emerging Risk Factors and Novel Therapeutic Targets. J Clin Med. 2023;12(6):2161.
22.Craciun LM, Buleu F, Pah AM, et al. The Benefits of a Comprehensive Cardiac Rehabilitation Program for Patients with Acute Coronary Syndrome: A Follow-Up Study. J Pers Med. 2023;13(10):1516.
23.Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on Cardiovascular Disease Prevention in Clinical Practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with a special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):23 15-2381.
24.Mozawa K, Kubota Y, Hoshika Y, et al. Empagliflozin confers reno-protection in acute myocardial infarction and type 2 diabetes mellitus. ESC Heart Fail. 2021;8(5): 4161-4173.
25.Kuno A, Kimura Y, Mizuno M, et al. Empagliflozin attenuates acute kidney injury after myocardial infarction in diabetic rats. Sci Rep. 2020;10(1):7238.
26.Carberry J, Petrie MC, Lee MMY, et al. Empagliflozin to prevent progressive adverse remodeling after myocardial infarction (EMPRESS-MI): rationale and design. ESC Heart Fail. 2024;11(4):2001-2012.
27.Neuen BL, Jun M, Wick J, et al. Estimating the population-level impacts of improved uptake of SGLT2 inhibitors in patients with chronic kidney disease: a cross-sectional observational study using routinely collected Australian primary care data. Lancet Reg Health West Pac. 2023;43:100988.
28.Hussain A, Ramsey D, Lee M, et al. Utilization Rates of SGLT2 Inhibitors Among Patients With Type 2 Diabetes, Heart Failure, and Atherosclerotic Cardiovascular Disease: Insights From the Department of Veterans Affairs. JACC Heart Fail. 2023;11 (8 Pt 1):933-942.
29.Li D, Wang T, Shen S, et al. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2017;19(3): 348-355.
30.Padda IS, Mahtani AU, Parmar M. Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. 2023 Jun 3. | ||
|
Statistics Article View: 47 PDF Download: 26 |
||