Effect of empagliflozin on reducing the no-reflow phenomenon in patients with ST-elevation myocardial infarction: rationale and design of the EMPA-PCI trial
Por:
Solis-Jimenez F., Araiza-Garaygordobil D., Masso-Bueso J.S., Villalobos-Ordaz A., Arellano-Juvera F., Arredondo-Aragon F., Melendez-Ramirez G., Valdez-Ortiz R., Alday-Ramirez S.M., Rodriguez-Zanella H.G., Amezcua Guerra L.M., Arias-Mendoza M.A., Martinez-Rios M.A., Arias-Sánchez E.A., Eid-Lidt G.
Publicada:
1 ene 2025
Resumen:
© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.Introduction Coronary no-reflow phenomenon occurs when cardiac tissue fails to perfuse normally despite opening of the occluded vessel. It is one of the manifestations of reperfusion injury, a series of pathological conditions associated with an increase in infarct size and adverse clinical outcomes. While there is currently no specific treatment to limit or prevent reperfusion injury, preclinical models have shown promising results with iSGLT2 inhibitors in this regard. However, there are no human studies specifically designed to evaluate the effects of empagliflozin on the no-reflow phenomenon or reperfusion injury. Methods and analysis The EMPA-PCI is a single-centre, open-label, randomized clinical trial that compares the use of empagliflozin vs. standard treatment in reducing reperfusion injury in patients with STEMI. A total of 162 patients will be randomized to receive either 25 mg of Empagliflozin as a loading dose before angioplasty followed by 10 mg per day for three doses in the treatment group, or standard treatment in the control group. The incidence of the no-reflow phenomenon during PCI, infarct size by magnetic resonance imaging, myocardial injury biomarkers will be compared. Clinical follow-up will be conducted for 3 months following patient enrollment. Conclusion Empagliflozin administered prior to PCI in patients with STEMI may contribute to prevent the no-reflow phenomenon and limit reperfusion injury. This could provide new insights into the cardiovascular benefits already known for SGLT2 inhibitors. Trial registration ClinicalTrials registry. NCT06342141.
Filiaciones:
Solis-Jimenez F.:
Department of Interventional Cardiology, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Medical School, National Autonomous University of México, Ciudad Universitaria, Coyoacán, 04510 Mexico City, Mexico
Araiza-Garaygordobil D.:
Department Coronary Care Unit, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Masso-Bueso J.S.:
Department of Interventional Cardiology, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Villalobos-Ordaz A.:
Medical School, Benemerita Autonomous University of Puebla, Sur 104 Centro Histórico C.P. 72000, Puebla,Mexico
Arellano-Juvera F.:
Medical School, Autonomous University of the State of Morelos, Av. Universidad No. 1001, Chamilpa, 62210 Cuernavaca, Morelos, Mexico
Arredondo-Aragon F.:
Medical School, National Autonomous University of México, Ciudad Universitaria, Coyoacán, 04510 Mexico City, Mexico
Melendez-Ramirez G.:
Department of Magnetic Resonance Imaging, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Valdez-Ortiz R.:
Department of Nephrology, General Hospital of Mexico Eduardo Liceaga, Dr. Balmis 148, Doctores, Cuauhtémoc, 06720 Mexico City, Mexico
Alday-Ramirez S.M.:
Department of Echocardiography, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Rodriguez-Zanella H.G.:
Department of Echocardiography, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Amezcua Guerra L.M.:
Department of Immunology, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Arias-Mendoza M.A.:
Department Coronary Care Unit, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Martinez-Rios M.A.:
Department of Interventional Cardiology, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Arias-Sánchez E.A.:
Department of Interventional Cardiology, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Medical School, National Autonomous University of México, Ciudad Universitaria, Coyoacán, 04510 Mexico City, Mexico
Eid-Lidt G.:
Department of Interventional Cardiology, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Dominguez Secc 16, Tlalpan, 14080 Mexico City, Mexico
Green Submitted, gold
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