Effects of empagliflozin in women and men with acute myocardial infarction: An analysis from the EMMY trial

Abstract

Objective: Women have a higher comorbidity burden and a lower survival rate after acute myocardial infarction (AMI) than men. This analysis aimed to investigate the impact of sex on the effect of treatment with the sodium glucose cotransporter 2 inhibitor (SGLT2i) empagliflozin immediately after an AMI.

Methods: Participants were randomized to either empagliflozin or placebo and followed for 26 weeks after initiating the treatment no later than 72 hours after a percutaneous coronary intervention following an AMI. We analyzed the impact of sex on the beneficial effects of empagliflozin observed for heart failure biomarkers as well as structural and functional cardiac parameters.

Results: Women had higher NT-proBNP levels at baseline (median 2117pg/mL, IQR 1383-3267 pg/mL versus 1137 pg/mL, IQR 695-2050 pg/mL; p < 0.001) and were older than men (median 61y, IQR 56-65y versus 56y, IQR 51-64y, p = 0.005). The beneficial effects of empagliflozin on NT-proBNP levels (P_interaction = 0.984), left ventricular ejection fraction (P_interaction = 0.812), left ventricular end systolic volume (P_interaction = 0.183), or left ventricular end diastolic volume (P_interaction = 0.676) were independent of sex.

Conclusions: Empagliflozin exhibited similar benefits in women and men when administered immediately after an AMI.

Keywords: Acute Myocardial Infarction; Cardiovascular Disease; Empagliflozin; SGLT2i; Sex Differences.