Copeptin Response to Empagliflozin in Patients with Recent Acute Coronary Syndrome and Newly Detected Dysglycaemia: a post-hoc analysis of the SOCOGAMI randomized controlled trial
Abstract
Abstract Background: Copeptin, a surrogate marker for vasopressin activity, is associated with cardiovascular disease, insulin resistance and glucose metabolism dysregulation. The cardioprotective effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) may involve vasopressin modulation through fluid redistribution, but whether this effect persists long-term in high-cardiovascular-risk patients with newly detected dysglycaemia remains unknown. Methods: In this post-hoc analysis of the SOCOGAMI double-blind, placebo-controlled trial, 42 patients (mean age 67.5 years, 19% female) with impaired glucose tolerance or newly diagnosed type 2 diabetes following an ACS and no heart failure were randomized to empagliflozin 25 mg/day (n=20) or placebo (n=22) for 7 months. Copeptin was serially measured during oral glucose tolerance tests (OGTT) at baseline, after 7 months on-treatment, and 3 months after treatment withdrawal. Treatment effects were assessed by repeated-measures ANOVA with treatment×time interaction and linear mixed-effects models. Results: Baseline copeptin did not differ between groups and correlated positively with arterial pulse wave velocity (r s =0.40, p=0.03), linking vasopressin activity to subclinical vascular stiffness. During treatment, a non-significant trend toward higher copeptin at 7 months in the empagliflozin group reversed to baseline after treatment discontinuation (treatment×time interaction p=0.64), with haematocrit showing a parallel…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 42 participants or records.
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