Re-Analyzing the EMPACT-MI Trial: A Pairwise Comparison Study of Empagliflozin After Heart Attack
Abstract
We will study whether a different way of analyzing trial results changes the conclusion about whether empagliflozin helps people recover after a heart attack. A heart attack happens when blood flow to part of the heart is suddenly blocked, usually by a clot in one of the heart's arteries and can damage the heart muscle within hours. Some people recover well, but others go on to develop a chronic condition called heart failure. Heart failure is different from a heart attack: it is a long-term condition in which the heart muscle — often weakened by a previous heart attack — can no longer pump blood effectively. People with heart failure may feel breathless, get tired easily, retain fluid in their legs and lungs, and need repeated hospital stays. Heart attacks affect millions of people each year, and preventing the heart failure that can follow them would benefit many patients and families. We will focus on the EMPACT-MI trial, which enrolled 6,522 patients in 22 countries and tested empagliflozin, a medicine first used for diabetes that also protects the heart. The trial asked whether the drug could reduce a combined outcome of heart failure hospitalizations and death after a recent heart attack. Using the standard analysis — which counts only the first event a patient experiences and treats heart failure hospitalization and death as equally important — the trial did not meet its main goal. However, the same data showed fewer heart failure hospitalizations with empagliflozin,…
Read the paper
Related studies
- Strategy for Mitigating DKA Risk in Patients with Type 1 Diabetes on Adjunctive Treatment with SGLT Inhibitors: A STICH Protocol
- Glucoraphanin: a broccoli sprout extract that ameliorates obesity-induced inflammation and insulin resistance
- SGLT2 Inhibitors in Heart Failure: Targeted Metabolomics and Energetic Metabolism
- Mechanisms of blood pressure reduction with sodium-glucose co-transporter 2 (SGLT2) inhibitors
- Sodium-glucose cotransporter inhibitors: beyond glycaemic control
- Decoding the effects of SGLT2 inhibitors on cardiac arrhythmias in heart failure
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.