The sodium-glucose cotransporter-2 inhibitors (SGLT2i) empagliflozin may be effective at lowering left ventricular (LV) mass in patients with type 2 diabetes and established coronary artery disease, according to results from the EMPA-HEART Cardiolink-6 Trial presented Nov. 11 at AHA 2018 in Chicago, IL.

Subodh Verma, MD, PhD, et al., looked at 152 patients between 40 and 80 years with type 2 diabetes (A1C ≥6.5 percent and ≤10 percent) and a prior history of either MI or coronary revascularization to evaluate the impact of SGLT2 inhibition with empagliflozin on LV remodeling.

Results showed that 10 mg of empagliflozin once a day for 6 months "significantly reduced" LV mass vs. placebo (adjusted difference (95 percent CI) between groups -3.35 (-5.9, -0.81) P=0.01). Researchers explain that "these benefits were seen in a normotensive population, with preserved ejection fraction, without known heart failure, and on top of standard of care therapies (with ≥80 percent on RAS blockers), and were greater in those with higher baseline LVMI."

The researchers conclude that their data suggests that empagliflozin "promotes early, statistically and clinically significant reverse remodeling which may contribute to the cardiovascular and heart failure benefits observed in the EMPA-REG OUTCOME trial and other SGLT2i studies."

"While the results are provocative, the small sample size limits the certainty of the effect. Larger studies are clearly needed," commented Kim A. Eagle, MD, MACC, editor-in-chief of ACC.org.

Keywords: AHA18, AHA Annual Scientific Sessions, Diabetes Mellitus, Type 2, Glucosides, Benzhydryl Compounds, Ventricular Function, Left, Coronary Disease

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