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- Dirk von Lewinski
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
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- Ewald Kolesnik
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
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- Norbert J Tripolt
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
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- Peter N Pferschy
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
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- Martin Benedikt
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
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- Markus Wallner
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
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- Hannes Alber
- Department of Cardiology, Public Hospital Klagenfurt am Woerthersee , Klagenfurt am Woerthersee , Austria
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- Rudolf Berger
- Department of Internal Medicine, Brothers of Saint John of God Eisenstadt , Eisenstadt , Austria
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- Michael Lichtenauer
- Department of Internal Medicine II, Division of Cardiology and Internal Intensive Care Medicine, Paracelsus Medical Private University Salzburg , Salzburg , Austria
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- Christoph H Saely
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT) , Feldkirch , Austria
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- Deddo Moertl
- Karl Landsteiner University of Health Sciences , 3050 Krems , Austria
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- Pia Auersperg
- Karl Landsteiner University of Health Sciences , 3050 Krems , Austria
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- Christian Reiter
- Department of Cardiology and Intensive Care Medicine, Kepler University Hospital Linz , Linz , Austria
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- Thomas Rieder
- Department of Medicine, Kardinal Schwarzenberg Hospital Schwarzach , Schwarzach , Austria
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- Jolanta M Siller-Matula
- Department of Cardiology, Medical University of Vienna , Vienna , Austria
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- Gloria M Gager
- Department of Cardiology, Medical University of Vienna , Vienna , Austria
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- Matthias Hasun
- 2nd Medical Department with Cardiology and Intensive Care Medicine, Hospital Landstrasse , Vienna , Austria
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- Franz Weidinger
- 2nd Medical Department with Cardiology and Intensive Care Medicine, Hospital Landstrasse , Vienna , Austria
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- Thomas R Pieber
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
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- Peter M Zechner
- Department of Cardiology and Intensive Care Medicine, Hospital Graz South West, West Location , Graz , Austria
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- Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz , Graz , Austria
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- Andreas Zirlik
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
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- Rury R Holman
- Radcliffe Department of Medicine, University of Oxford , Oxford , UK
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- Abderrahim Oulhaj
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University , Abu Dhabi , UAE
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- Harald Sourij
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz , Austria
抄録
<jats:title>Abstract</jats:title><jats:sec><jats:title>Aims</jats:title><jats:p>Sodium–glucose co-transporter 2 inhibition reduces the risk of hospitalization for heart failure and for death in patients with symptomatic heart failure. However, trials investigating the effects of this drug class in patients following acute myocardial infarction are lacking.</jats:p></jats:sec><jats:sec><jats:title>Methods and results</jats:title><jats:p>In this academic, multicentre, double-blind trial, patients (n = 476) with acute myocardial infarction accompanied by a large creatine kinase elevation (>800 IU/L) were randomly assigned to empagliflozin 10 mg or matching placebo once daily within 72 h of percutaneous coronary intervention. The primary outcome was the N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP) change over 26 weeks. Secondary outcomes included changes in echocardiographic parameters. Baseline median (interquartile range) NT-proBNP was 1294 (757–2246) pg/mL. NT-proBNP reduction was significantly greater in the empagliflozin group, compared with placebo, being 15% lower [95% confidence interval (CI) −4.4% to −23.6%] after adjusting for baseline NT-proBNP, sex, and diabetes status (P = 0.026). Absolute left-ventricular ejection fraction improvement was significantly greater (1.5%, 95% CI 0.2–2.9%, P = 0.029), mean E/e′ reduction was 6.8% (95% CI 1.3–11.3%, P = 0.015) greater, and left-ventricular end-systolic and end-diastolic volumes were lower by 7.5 mL (95% CI 3.4–11.5 mL, P = 0.0003) and 9.7 mL (95% CI 3.7–15.7 mL, P = 0.0015), respectively, in the empagliflozin group, compared with placebo. Seven patients were hospitalized for heart failure (three in the empagliflozin group). Other predefined serious adverse events were rare and did not differ significantly between groups.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In patients with a recent myocardial infarction, empagliflozin was associated with a significantly greater NT-proBNP reduction over 26 weeks, accompanied by a significant improvement in echocardiographic functional and structural parameters.</jats:p></jats:sec><jats:sec><jats:title>ClinicalTrials.gov registration</jats:title><jats:p> NCT03087773.</jats:p></jats:sec>
収録刊行物
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- European Heart Journal
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European Heart Journal 43 (41), 4421-4432, 2022-08-29
Oxford University Press (OUP)