Hernandez, Adrian FUdell, Jacob AJones, W SchuylerAnker, Stefan DPetrie, Mark CHarrington, JosephineMattheus, MichaelaSeide, SvenjaZwiener, IsabellaAmir, OfferBahit, M CeciliaBauersachs, JohannBayes-Genis, AntoniChen, YundaiChopra, Vijay KA Figtree, GemmaGe, JunboG Goodman, ShaunGotcheva, NinaGoto, ShinyaGasior, TomaszJamal, WaheedJanuzzi, James LJeong, Myung HoLopatin, YuriLopes, Renato DMerkely, BélaParikh, Puja BParkhomenko, AlexanderPonikowski, PiotrRosselló, XavierSchou, MortenSimic, DraganSteg, Philippe GabrielSzachniewicz, Joannavan der Meer, PeterVinereanu, DragosZieroth, ShelleyBrueckmann, MartinaSumin, MikhailBhatt, Deepak LButler, Javed2024-09-102024-09-102024-05-21Hernandez AF, Udell JA, Jones WS, Anker SD, Petrie MC, Harrington J, et al. Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial. Circulation. 2024 May 21;149(21):1627–38.https://hdl.handle.net/20.500.13003/20976Empagliflozin 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. 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. 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). Empagliflozin reduced the risk of HF in patients with left ventricular dysfunction or congestion after acute myocardial infarction. URL: https://www.clinicaltrials.gov; Unique identifier: NCT04509674.engAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/AgedBenzhydryl CompoundsHumansMiddle AgedDouble-Blind MethodGlucosidesHeart FailureMyocardial InfarctionHospitalizationSodium-Glucose Transporter 2 InhibitorsMaleFemaleStroke VolumeTreatment Outcomeresearch articleInhibidores del Cotransportador de Sodio-Glucosa 2Resultado del TratamientoFemeninoInfarto del MiocardioVolumen SistólicoHospitalizaciónMasculinoMétodo Doble CiegoGlucósidosInsuficiencia CardíacaHumanosPersona de Mediana EdadAncianoCompuestos de BencidriloGlucosidesBenzhydryl CompoundsHeart FailureMyocardial InfarctionSodium-Glucose Transporter 2 InhibitorsHospitalizationHumansMaleFemaleAgedMiddle AgedDouble-Blind MethodTreatment OutcomeStroke Volume10.1161/CIRCULATIONAHA.124.0692171524-453938581389L20324614572-s2.0-85192082139001290801600001open access