Empagliflozin preserved kidney function and was safe to initiate in heart attack patients, findings of a secondary analysis of the EMPACT-MI trial, published in nature cardiovascular research have shown.
EMPACT-MI is a multicentre, randomised, parallel-group, double-blind, placebo-controlled superiority trial investigating the effect of the SGLT2 inhibitor empagliflozin on all-cause mortality and hospitalisation due to heart failure in adults who have had a heart attack.
SGLT2 inhibitors have become a common treatment for diabetes, heart failure, and chronic kidney disease, but questions over their safety due to potential harm to kidney function in potentially unstable patients have been asked.
Participants in EMPACT-MI had no history of chronic heart failure and were eligible regardless of type 2 diabetes and chronic kidney disease status. The study included more than 6,500 adults from 22 countries, who were randomised to receive either empagliflozin (10mg) or placebo, once daily, both on top of standard of care within 14 days of hospital admission for heart attack. Patients were followed for an average of a year and a half.
This secondary analysis of the EMPACT-MI trial demonstrated that the SGLT2 inhibitor empagliflozin preserved kidney function and was safe to initiate in heart attack patients. Researchers found that after heart attack patients were on the drug for two years, their kidney function was stable and unharmed, while patients on placebo had significant worsening of their kidney function.
Even in heart attack patients with poor kidney function, researchers found SGLT2 inhibitors reduced heart failure complications.
“SGLT2 inhibitors are underused in clinical practice. These data provide reassurance of the safety of using this class of drugs when indicated—even in patients after a recent heart attack and if the kidney function is impaired,” says the study’s lead investigator Deepak L Bhatt (Mount Sinai Fuster Heart Hospital and Icahn School of Medicine at Mount Sinai, New York, USA).
