Empagliflozin in Patients With Acute Myocardial Infarction - EMMY

Sep 09, 2022
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Author/Summarized by Author:
Dharam J. Kumbhani, MD, SM, FACC
Summary Reviewer:
Deepak L. Bhatt, MD, MPH, MBA, FACC
Trial Sponsor:
Boehringer Ingelheim
Date Presented:
08/29/2022
Date Published:
08/29/2022
Date Updated:
09/09/2022
Original Posted Date:
08/29/2022
References

Contribution To Literature:

The EMMY trial showed that acute administration of empagliflozin 10 mg is superior to placebo in reducing NT-proBNP levels at 26 weeks among patients with AMI.

Description:

The goal of the trial was to assess the safety and efficacy of empagliflozin in patients with acute myocardial infarction (AMI).

Study Design

Patients were randomized in a 1:1 fashion to either empagliflozin 10 mg (n = 237) or matching placebo (n = 239).

  • Total number of enrollees: 476
  • Duration of follow-up: 26 weeks
  • Median patient age: 57 years
  • Percentage female: 18%

Inclusion criteria:

  • Patients with AMI with elevated creatine kinase (>800 U/L) and troponin (>10x upper limit of normal [ULN]), suggesting major myocardial necrosis

Other salient features/characteristics:

  • Type 2 diabetes mellitus: 13%
  • Baseline geometric mean N-terminal pro–B-type natriuretic peptide (NT-proBNP): 1307 pg/ml

Principal Findings:

The primary outcome, crude geometric mean NT-proBNP reduction compared with baseline, for empagliflozin vs. placebo, was: -85% vs. -81.7%, p < 0.05 (adjusted for baseline NT-proBNP level, sex, and diabetes).

Secondary outcome for empagliflozin vs. placebo:

  • Hospitalization for heart failure: 3 vs. 4 patients

Interpretation:

The results of this trial indicate that acute administration of empagliflozin 10 mg is superior to placebo in reducing NT-proBNP levels at 26 weeks among patients with AMI. The majority of patients in this trial did not have type 2 diabetes mellitus. This is a small trial; clinical outcomes are unclear.

References:

von Lewinski D, Kolesnik E, Tripolt NJ, et al., on behalf of the EMMY Investigators. Empagliflozin in acute myocardial infarction: the EMMY trial. Eur Heart J 2022;Aug 29:[Epub ahead of print].

Presented by Dr. Harald Sourij at the European Society of Cardiology Congress (ESC 2022), Barcelona, Spain, August 29, 2022.

Clinical Topics: Acute Coronary Syndromes, Heart Failure and Cardiomyopathies, ACS and Cardiac Biomarkers, Acute Heart Failure, Heart Failure and Cardiac Biomarkers

Keywords: ESC22, ESC Congress, Acute Coronary Syndrome, Creatine Kinase, Diabetes Mellitus, Type 2, Heart Failure, Myocardial Infarction, Natriuretic Peptide, Brain, Necrosis, Troponin


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