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The New England Journal of MedicineEmpagliflozin after Acute Myocardial Infarction

Examining Empagliflozin’s Impact on Heart Failure and Survival Post-Myocardial Infarction

Recent research explores the efficacy and safety of empagliflozin for patients at risk of heart failure after experiencing an acute myocardial infarction. This study, rigorously designed as a double-blind, randomized, placebo-controlled trial, investigates whether empagliflozin can reduce hospitalizations for heart failure or death in this high-risk patient group.

Study Design:

  • Type of Study: Event-driven, double-blind, randomized, placebo-controlled trial.
  • Participants: 6,522 patients hospitalized for acute myocardial infarction, at risk for heart failure.
  • Intervention: Patients were randomized in a 1:1 ratio to receive either 10 mg daily of empagliflozin or a placebo, in addition to standard care.
  • Duration: Follow-up for a median of 17.9 months.
  • Primary Endpoint: Composite of hospitalization for heart failure or death from any cause.

Key Findings:

  • Overall Results: No significant difference in the risk of the primary endpoint between empagliflozin and placebo groups (hazard ratio, 0.90; 95% CI, 0.76 to 1.06; P=0.21).
  • Heart Failure Hospitalizations: Empagliflozin group saw a reduction in the risk of first hospitalization for heart failure compared to placebo (hazard ratio, 0.77; 95% CI, 0.60 to 0.98).
  • Mortality Rate: Similar death rates observed in both groups (5.2% empagliflozin vs 5.5% placebo; hazard ratio, 0.96; 95% CI, 0.78 to 1.19).
  • Adverse Events: Comparable between both groups, consistent with empagliflozin’s known safety profile.

HCN Medical Memo
Although empagliflozin shows a promising reduction in hospitalizations for heart failure among patients post-myocardial infarction, its overall impact on survival rates mirrors that of standard care. This information could be crucial for refining treatment protocols and managing patient expectations in clinical practice.

More on Myocardial Infarction

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