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SHR Neuro Cancer Cardio Lipid Metab Microb
Benedikt, M; Mangge, H; Aziz, F; Curcic, P; Pailer, S; Herrmann, M; Kolesnik, E; Tripolt, NJ; Pferschy, PN; Wallner, M; Zirlik, A; Sourij, H; von, Lewinski, D.
Impact of the SGLT2-inhibitor empagliflozin on inflammatory biomarkers after acute myocardial infarction - a post-hoc analysis of the EMMY trial.
Cardiovasc Diabetol. 2023; 22(1): 166
Doi: 10.1186/s12933-023-01904-6
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- Leading authors Med Uni Graz
- Benedikt Martin
- Sourij Harald
- von Lewinski Dirk
- Co-authors Med Uni Graz
- Aziz Faisal
- Curcic Pero
- Herrmann Markus
- Kolesnik Ewald
- Mangge Harald
- Pailer Sabine
- Pferschy Peter
- Tripolt Norbert
- Wallner Markus
- Zirlik Andreas
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- Abstract:
- BACKGROUND: SGTL2-inhibitors are a cornerstone in the treatment of heart failure, but data on patients with acute myocardial infarction (AMI) is limited. The EMMY trial was the first to show a significant reduction in NTproBNP levels as well as improved cardiac structure and function in post-AMI patients treated with Empagliflozin compared to placebo. However, data on the potential impact of SGLT2-inhibitors on inflammatory biomarkers after AMI are scarce. MATERIALS AND METHODS: The EMMY trial is an investigator-initiated, multicentre, double-blind, placebo-controlled trial, which enrolled patients after AMI, receiving either 10 mg Empagliflozin once daily or placebo over a period of 26 weeks on top of standard guideline-recommended therapy starting within 72 h after percutaneous coronary intervention. In this post-hoc subgroup analysis of the EMMY trial, we investigated inflammatory biomarkers of 374 patients. The endpoints investigated were the mean change in inflammatory biomarkers such as high-sensitive c-reactive protein (hsCRP), interleukin-6 (IL-6), neutrophils, leukocytes, neutrophile/lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) from baseline to 26 weeks. RESULTS: Baseline median (interquartile ranges) IL-6 was 17.9 pg/mL (9.0-38.7), hsCRP 18.9 mg/L (11.2-37.1), neutrophil count 7.9 x G/L (6.2-10.1), leukocyte count 10.8 x G/L (9.1-12.8) and neutrophile/lymphocyte ratio (NLR) of 0.74 (0.67-0.80). At week 26, a significant mean reduction in inflammatory biomarkers was observed, being 35.1 ± 3.2% (p < 0.001) for IL-6, 57.4 ± 0.7% (p < 0.001) for hsCRP, 26.1 ± 0.7% (p < 0.001) for neutrophils, 20.5 ± 0.6% (p < 0.001) for leukocytes, 10.22 ± 0.50% (p < 0.001) for NLR, and - 2.53 ± 0.92% for PLR (p = 0.006) with no significant difference between Empagliflozin and placebo treatment. CONCLUSION: Trajectories of inflammatory biomarkers showed a pronounced decline after AMI, but Empagliflozin treatment did not impact this decline indicating no central role in blunted systemic inflammation mediating beneficial effects.
- Find related publications in this database (Keywords)
- Empagliflozin
- Myocardial infarction
- Inflammation
- Interleukin-6
- High-sensitive c-reactive protein