Evaluating the Effect of Empagliflozin on Coronary No-Reflow in percutaneous coronary intervention in patients with Non-ST Elevation Myocardial Infarction
Abstract
This research project aims to evaluate the impact of empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, on the occurrence of the coronary no-reflow phenomenon during percutaneous coronary intervention (PCI) in patients with Non-ST Elevation Myocardial Infarction (NSTEMI). NSTEMI is a common form of acute coronary syndrome, associated with myocardial necrosis without persistent ST-segment elevation, and often occurs in older patients with multiple comorbidities. A frequent and serious complication during PCI in these patients is the no-reflow phenomenon, characterized by inadequate myocardial perfusion despite successful mechanical reopening of the coronary artery. This complication is linked to larger infarct sizes, adverse ventricular remodeling, and increased morbidity and mortality. The pathophysiology of no-reflow is multifactorial, involving microvascular obstruction, ischemia-reperfusion injury, oxidative stress, endothelial dysfunction, and inflammation. Empagliflozin has shown promising cardiovascular benefits beyond glucose lowering, including improved endothelial function, reduced oxidative stress, and attenuation of inflammatory responses, which may counteract the mechanisms leading to no-reflow. The study will be a prospective, randomized, controlled, double-blind trial conducted at Menoufia University Hospitals and Damanhour Medical National Institute, Cardiology Departments. Eligible adult patients with confirmed NSTEMI scheduled for early…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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