Heart failure & cardiomyopathiesSecondary analysis
Empagliflozin in Acute Myocardial Infarction in Patients with and Without Type 2 Diabetes: A Pre-Specified Analysis of the EMPACT-MI Trial
- Secondary analysis of the EMPACT-MI randomised trial
- pre-specified analysis
Authors' conclusion
Patients with acute MI, LVEF <45% and/or congestion who had T2DM were at a higher risk of mortality than those without T2DM. Empagliflozin reduced first and total HF hospitalizations regardless of the presence or absence of T2DM.
Study context
- Population
- Patients with acute myocardial infarction (MI) with newly reduced left ventricular ejection fraction (LVEF) <45%, congestion, or both, with and without T2DM32% T2DM
- Participants
- 6,522 patients
- Comparison
- Empagliflozin vs placebo, by T2DM status
- Primary endpoint
- Time to first HF hospitalization or all-cause death
Primary result
As reported in the abstract
Empagliflozin effect by T2DM status
- Empagliflozin reduced first and total heart failure (HF) hospitalizations, but not all-cause mortality, regardless of T2DM
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Risk with T2DM vs without T2DM — T2DM vs No T2DM · first HF hospitalization or all-cause death | 1.44 (1.06–1.95) | |
| Risk with T2DM vs without T2DM — T2DM vs No T2DM · all-cause death | 1.70 (1.13–2.56) | |
| Risk with T2DM vs without T2DM — T2DM vs No T2DM · first HF hospitalization | 1.22 (0.82–1.83) | |
| 0.20.5125Hazard ratio (log scale) |
Glycaemic status
- T2DM
- 32%
- Pre-diabetes
- 14%
- Normoglycaemic
- 16%
- Unknown glycaemic status
- 38%
Safety
Safety by T2DM status
- Safety profile of empagliflozin the same with and without T2DM
Original publication
Empagliflozin in Acute Myocardial Infarction in Patients with and Without Type 2 Diabetes: A Pre-Specified Analysis of the EMPACT-MI Trial. Eur J Heart Fail. Published 26 December 2024. doi:10.1002/ejhf.3548
Summarised from the published abstract; every number is checked against it