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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Benedikt, M; Aziz, F; Fröschl, T; Strohhofer, C; Kolesnik, E; Tripolt, N; Pferschy, P; Wallner, M; Bugger, H; Zirlik, A; Scherr, D; Sourij, H; von, Lewinski, D.
Impact of baseline ECG characteristics on changes in cardiac biomarkers and echocardiographic metrices after acute myocardial infarction treated with Empagliflozin.
Sci Rep. 2024; 14(1): 15083 Doi: 10.1038/s41598-024-64175-5 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Benedikt Martin
von Lewinski Dirk
Co-Autor*innen der Med Uni Graz
Aziz Faisal
Bugger Heiko Matthias
Fröschl Thomas
Kolesnik Ewald
Pferschy Peter
Scherr Daniel
Sourij Harald
Strohhofer Christoph
Tripolt Norbert
Wallner Markus
Zirlik Andreas
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Abstract:
The EMMY trial was a multicentre, investigator-initiated, placebo-controlled, double-blind trial, which enrolled 476 patients immediately following AMI and the first study demonstrating a significant reduction in NT-proBNP-levels as well as significant improvements in cardiac structure and function in patients after acute myocardial infarction treated with empagliflozin vs. placebo. However, hardly any data are available investigating the prognostic role of baseline electrocardiogram metrics in SGLT2-inhibitor-treated patients. This post-hoc analysis investigated the association of baseline ECG metrics collected in one centre of the trial (181 patients) with changes in structural and functional cardiac parameters as well as cardiac biomarkers in response to Empagliflozin treatment. A total of 181 patients (146 men; mean age 58 ± 14 years) were included. Median PQ-interval was 156 (IQR 144-174) milliseconds (ms), QRS width 92 (84-98) ms, QTc interval 453 (428-478) ms, Q-wave duration 45 (40-60) ms, Q-wave amplitude 0.40 (0.30-0.70) millivolt (mV), and heart rate was 71 (64-85) bpm. For functional cardiac parameters (LVEF and E/e') of the entire cohort, a greater decrease of E/e' from baseline to week 26 was observed in shorter QRS width (P = 0.005).Structural cardiac endpoints were only found to have a significant positive correlation between LVEDD and Q wave duration (P = 0.037). Higher heart rate was significantly correlated with better response in LVEF (P = 0.001), E/e' (P = 0.021), and NT-proBNP (P = 0.005). Empagliflozin-treatment showed no interaction with the results. Baseline ECG characteristics post AMI are neither predictive for beneficial NTproBNP effects of Empagliflozin post AMI, nor for functional or structural changes within 26 weeks post AMI.
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Empagliflozin
Myocardial infarction
Electrocardiogram
Heart failure
Electric conduction
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