Efficacy of Empagliflozin Versus Placebo in Patients With Recent Acute Myocardial Infarction: A Systematic Review

Empagliflozin, a sodium-glucose cotransporter-2 inhibitor (SGLT2), is well-established for managing various cardio-renal conditions, but its effectiveness in patients recovering from acute myocardial infarction (AMI) remains unclear. This systematic review aims to evaluate whether empagliflozin reduces mortality and hospitalization rates compared to placebo in this population. We identified five randomized controlled trials (RCTs) from PubMed and ScienceDirect up to May 2024, which compared empagliflozin to placebo in patients with recent AMI. A total of 7229 participants were included. The primary outcomes were reductions in mortality and hospitalization rates, while secondary outcomes included changes in N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and left ventricular ejection fraction (LVEF). Empagliflozin did not significantly reduce cardiovascular mortality or hospitalization rates. However, some studies reported a statistically significant reduction in NT-proBNP levels of up to 15% in the empagliflozin group. Additionally, a 1.5% greater increase in LVEF was observed in patients treated with empagliflozin compared to placebo in certain studies. Although empagliflozin has a favorable safety profile and shows positive effects on biomarkers related to heart failure (HF), current evidence does not support its use as an effective intervention for reducing mortality or hospitalizations in AMI patients. Further research is needed to confirm its efficacy in this population.