EMPACT-MI: Empagliflozin after MI

empact mi trial empagliflozin

Year: 2024 Title: EMPACT-MI Subtitle: Empagliflozin after Acute Myocardial Infarction Type of Trial: A double-blind, randomized, placebo-controlled trial

Objective: To assess if the use of empagliflozin in the treatment of acute myocardial infarction (AMI) affects future mortality or heart failure (HF) in at-risk patients.

Patients: 6522

Inclusion Criteria:

  • Age ≥18 years
  • Diagnosed cases of spontaneous acute MI
  • Had been hospitalized for acute MI and were at risk for heart failure.

Exclusion Criteria:

  • Diagnosis of CHF before index MI
  • Systolic BP <90 mmHg at randomization
  • Cardiogenic shock or use of i.v. inotropes in the last 24 hours before randomization


  • Empagliflozin (10 mg daily) group (n = 3260)
  • Placebo group (n = 3262)

Primary Outcome:

  • First hospitalization for heart failure or death from any cause in patients (%)
    • HR 0.90; 95% CI, 0.76 to 1.06 (P=0.21)
    • Empagliflozin group: 8.2%
    • Placebo group: 9.1%

Secondary Outcomes:

  1. First hospitalization for heart failure occurred in patients (%)
    • HR 0.77; 95% CI, 0.60 to 0.98
    • Empagliflozin group: 3.6%
    • Placebo group: 4.7%
  2. Death from any cause (%)
    • HR 0.96; 95% CI, 0.78 to 1.19
    • Empagliflozin group: 5.2%
    • Placebo group: 5.5%

Conclusion: Among patients at increased risk for heart failure after acute myocardial infarction, treatment with empagliflozin did not lead to a significantly lower risk of a first hospitalization for heart failure or death from any cause than placebo.

Reference: Butler J et al. N Engl J Med 2024; DOI: 10.1056/NEJMoa2314051

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