{"id":"3f0471e66196","type":"article","url":"https://hartvaat.nl/2022/11/01/emmy-empagliflozine-na-acuut-myocardinfarct-verbetert-nt-probnp-en-remodelling/","title":"EMMY: empagliflozine na acuut myocardinfarct verbetert NT-proBNP en remodelling","title_en":"Empagliflozin in acute myocardial infarction: the EMMY trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","canagliflozine","dapagliflozine","empagliflozine","emperor-trials","myocardinfarct","nt-probnp"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehac494","source_url":"https://doi.org/10.1093/eurheartj/ehac494","authors":["Dirk von Lewinski","Ewald Kolesnik","Norbert J Tripolt","Peter N Pferschy","Martin Benedikt","Markus Wallner","Hannes Alber","Rudolf Berger","Michael Lichtenauer","Christoph H Saely","Deddo Moertl","Pia Auersperg","Christian Reiter","Thomas Rieder","Jolanta M Siller-Matula","Gloria M Gager","Matthias Hasun","Franz Weidinger","Thomas R Pieber","Peter M Zechner","Markus Herrmann","Andreas Zirlik","Rury R Holman","Abderrahim Oulhaj","Harald Sourij"],"significance":8,"published":"2022-11-01","source_date":"2022-11-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/esc-richtlijn-hartfalen-2021/","https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/"],"congress":"","summary_en":"The EMMY trial showed that empagliflozin started after acute MI significantly reduced NT-proBNP levels and attenuated left ventricular remodeling compared with placebo. The results provided early evidence of SGLT2 inhibitor cardioprotection in the acute post-MI setting.","created":"2026-07-03T10:30:03Z","updated":"2026-07-03T18:38:57Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De EMMY-trial toonde dat empagliflozine gestart na acuut MI het NT-proBNP significant verlaagde en de linkerventrikelremodelling verminderde na 26 weken. Dit opent de deur voor SGLT2-remmers als vroege therapie na myocardinfarct, ongeacht diabetes of hartfalen.","abstract_original":"AIMS: 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. METHODS AND RESULTS: 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. CONCLUSION: 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. CLINICALTRIALS.GOV REGISTRATION: NCT03087773."}