EMMY: The continued expansion of clinical applications of SGLT2 inhibitors

Abstract

Study and Results: The EMMY trial was conducted to assess the safety and efficacy of empagliflozin in patients with acute myocardial infarction (AMI). A total of 476 patients with AMI were randomly assigned to empagliflozin (10 mg) or matching placebo once daily within 72 h of percutaneous coronary intervention. The primary outcome was the N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP) change over 26 weeks. Secondary outcomes included changes in echocardiographic parameters. NT-proBNP reduction was significantly greater in the empagliflozin group (-15% after adjusting for baseline NT-proBNP, gender, and diabetes status (P=0.026)). Absolute left-ventricular ejection fraction improvement was 1.5% (P = 0.029) greater, mean E/e′ reduction was 6.8% (P = 0.015) greater, and left-ventricular end-systolic and end-diastolic volumes were lower by 7.5 mL (P = 0.0003) and 9.7 mL (P =0.0015), respectively, in the empagliflozin group, compared with placebo. Seven patients were hospitalized for HF (3 in the empagliflozin group). Other predefined serious adverse events were rare and did not differ significantly between groups.