Promising Drug Combination for Early Post-Myocardial Infarction Treatment

Researchers from the Germans Trias i Pujol Research Institute (IGTP) have explored innovative approaches to improve recovery after a myocardial infarction, commonly known as a heart attack. This preclinical study examined the effects of the drug empagliflozin, alone and in combination with sacubitril/valsartan, on heart healing in a pig model. Results indicated that the combination therapy was particularly effective in reducing harmful tissue remodeling and arrhythmogenic risks, showing promise for future clinical applications.

Myocardial infarction remains a leading cause of death worldwide, often resulting in lasting heart damage. When a heart attack occurs, a blocked artery deprives part of the heart muscle of oxygen, causing tissue death and triggering an inflammatory response. The healing process involves scar formation, which, while essential for structural integrity, does not contract and can impair heart function over time. This can lead to changes in heart shape, decreased pumping capacity, and increased risk of dangerous arrhythmias and heart failure.

Recent advances in medications like sacubitril/valsartan and empagliflozin have improved the management of chronic heart failure. Sacubitril/valsartan combines drugs that regulate blood pressure and fluid balance, reducing inflammation and preventing fibrosis. Empagliflozin, initially developed for diabetes, has demonstrated protective effects on the heart by decreasing inflammation, oxidative stress, improving energy utilization, and increasing beneficial molecules like nitric oxide.

Despite these benefits in ongoing heart failure treatment, their roles immediately after a heart attack are not well understood. The IGTP team investigated this gap by conducting a study in pigs with induced myocardial infarction. They tested how empagliflozin alone and combined with sacubitril/valsartan affected inflammation, scar tissue composition, cardiac function, and arrhythmia susceptibility.

The findings showed that empagliflozin alone effectively lowered inflammation and increased nitric oxide levels, influencing scar composition; however, it did not significantly improve overall heart function or reduce arrhythmias. Conversely, combining empagliflozin with sacubitril/valsartan resulted in less collagen buildup, reduced ventricular remodeling, and a lower tendency for arrhythmias, indicating a more favorable healing process.

Principal investigators Dr. Felipe Bisbal and Dr. Carolina Gálvez-Montón highlighted the significance of these results, emphasizing the anti-inflammatory and cardioprotective potential of combining these drugs during the critical early phase after a myocardial infarction. The study, part of a doctoral thesis by Daina Martínez, advocates for future human trials to confirm these benefits, optimize treatment timing, doses, and combinations for post-heart attack patients.

This research paves the way for new therapeutic strategies aimed at reducing long-term complications of heart attacks and improving recovery outcomes, with ongoing studies needed to translate these promising results into clinical practice.