Dapagliflozin Effects in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary...

Acute myocardial infarction (MI) is associated with a high incidence of morbidity and mortality. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are antidiabetic medications known for their favorable effects on cardiovascular disease. However, evidence regarding their effects in acute MI is limited.

Whether early administration of dapagliflozin could affect the cardiovascular outcome of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

We randomly allocated 101 patients with nondiabetes, nonheart failure STEMI undergoing primary PCI to receive dapagliflozin (10 mg/d started before PCI and continued for 40 days) or placebo.

The primary outcomes were changes in left ventricular ejection fraction (LVEF) 40 days after PCI, changes in cardiac troponin I (cTnI) levels, estimated infarct size using the peak and area under the curve (AUC) of cTnI, and ST-segment resolution. Secondary outcomes included high-sensitivity C-reactive (hs-CRP) protein levels at discharge and health-related quality of life (HRQoL) 40 days after acute MI.

The results revealed a significant increase in LVEF in dapagliflozin-treated patients with baseline LVEF ≤40% compared with the placebo group (41.1 ± 5.5 vs. 38.1 ± 6.9; P = 0.037). No significant difference was observed regarding ST-segment resolution, cTnI levels, AUC, and peak between the 2 groups. We did not observe a significant difference regarding secondary outcomes.

This study showed that dapagliflozin could significantly improve LVEF among patients whose LVEF dropped to ≤40% post-STEMI. However, further studies are required to confirm the study findings.