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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Empagliflozin and colchicine in patients with reduced left ventricular ejection fraction following ST-elevation

Sajad Khiali1, Mohammadreza Taban-Sadeghi2, Parvin Sarbakhsh3

  • 1Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.

Trials
|October 6, 2023
PubMed

Insights

This study investigates empagliflozin and colchicine for non-diabetic patients post-myocardial infarction with reduced ejection fraction. It aims to improve cardiovascular outcomes and reduce heart failure risk.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Patients with acute myocardial infarction face high risks of chronic heart failure and mortality.
  • Limited evidence exists on sodium-glucose cotransporter-2 inhibitors for cardiovascular outcomes in non-diabetic patients post-myocardial infarction with reduced ejection fraction.
  • The combined effects of empagliflozin and colchicine, or high-dose empagliflozin, remain unevaluated in this patient group.

Purpose of the Study:

  • To evaluate the efficacy and safety of early treatment with empagliflozin (standard and high dose) and a combination of empagliflozin and colchicine.
  • To assess the impact of these treatments on New York Heart Association functional classification and high-sensitivity C-reactive protein levels.
  • To explore novel therapeutic strategies for non-diabetic patients with reduced ejection fraction following ST-elevation myocardial infarction.

Main Methods:

  • A prospective, double-blinded, placebo-controlled randomized trial involving 105 patients.
  • Patients with reduced left ventricular ejection fraction (≤40%) post-ST-elevation myocardial infarction were randomized.
  • Treatment arms included empagliflozin 10 mg daily, empagliflozin 10 mg daily plus colchicine 0.5 mg twice daily, or empagliflozin 25 mg daily for 12 weeks.

Main Results:

  • Primary outcomes include changes in New York Heart Association functional classification and high-sensitivity C-reactive protein at 4 and 12 weeks.
  • The study will provide data on the comparative effectiveness of different empagliflozin dosages and the combination therapy.
  • Safety profiles of the investigated treatment regimens will be assessed.

Conclusions:

  • This trial is the first to examine the combination of standard-dose empagliflozin and colchicine, and high-dose empagliflozin in non-diabetic patients post-myocardial infarction with reduced ejection fraction.
  • The findings are expected to significantly advance the treatment strategies for this vulnerable patient population.
  • Results will inform clinical practice regarding early therapeutic interventions to mitigate adverse cardiovascular events.
Abstract

Keywords:
Clinical trialColchicineEmpagliflozinHeart failureLVSDMyocardial infarction

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