Empagliflozin improves left ventricular ejection fraction and end systolic volume in patients with type 2 diabetes mellitus and coronary artery disease: a post-hoc analysis of EMPA-CARD trial

Samin Ghanbari; Sepehr Gohari; Tara Reshadmanesh; Mahsa Mahjani; Shahram Arsang-Jang; Faramarz Ismail-Beigi; Mohsen Dadashi; Hossein Chiti; Atieh Asgari; Homa Taheri; Ozra Zolfkhani; Hassan Ahangar

doi:10.1007/s40200-024-01393-8

Empagliflozin improves left ventricular ejection fraction and end systolic volume in patients with type 2 diabetes mellitus and coronary artery disease: a post-hoc analysis of EMPA-CARD trial

J Diabetes Metab Disord. 2024 Mar 7;23(1):1107-1111. doi: 10.1007/s40200-024-01393-8. eCollection 2024 Jun.

Affiliations

¹ Department of Cardiology, School of Medicine, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
² Student Research Center, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
³ Endocrine Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Department of Biostatistics, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
⁵ Department of Medicine, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH USA.
⁶ Endocrinology and Metabolism research Centre, School of Medicine, Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.

PMID: 38932825
PMCID: PMC11196504 (available on 2025-03-07)
DOI: 10.1007/s40200-024-01393-8

Abstract

Background: Sodium glucose co-transporter2 (SGLT2) inhibitors have exhibited cardioprotective properties in diabetes patients. The aim of this study was to investigate the effect of Empagliflozin on changes in echocardiographic parameters.

Methods: This was a post hoc analysis of the EMPA-CARD trial which was a multicenter, triple-blind randomized controlled trial. Type 2 diabetes mellitus patients with concomitant history of coronary artery disease were randomized on a 1:1 ratio into two groups receiving either 10 mg/day Empagliflozin or placebo. Patients with a history of heart failure (NYHA class 3-4) and ejection fraction (EF) < 40% were excluded. Trans-thoracic echocardiography was performed at baseline and at 26 weeks of intervention.

Results: A total of 69 (Empagliflozin = 39 and placebo = 30) patients underwent echocardiography. Significant changes were observed for left ventricular ejection fraction [standard error (SE) = 0.76; beta (95% correlation interval (CrI)] = -5.558 (-7.25; -4.18) and left ventricular end-systolic volume (SE = 1.38; beta (95% CrI) = 3.915 (1.2; 0.66). Other echocardiographic parameters relating to right ventricular or atrial function did not change significantly.

Conclusion: Empagliflozin can have cardioprotective benefits in subjects without HF. Further studies are required to determine the effect of Empagliflozin in non-HF patients.

Trial registration: The original EMPA-CARD study has been registered in Iranian Registry of Clinical Trials. www.IRCT.ir, Identifier: IRCT20190412043247N2. Registration Date: 6/13/2020. Registration timing: prospective.

Keywords: Coronary artery disease; Diabetes Mellitus; Echocardiography; Empagliflozin; SGLT2 inhibitor.

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