SGLT2 Inhibitors Show Safety and Efficacy for Kidney Preservation After Heart Attack

Recent research highlights the promising role of SGLT2 inhibitors, a class of drugs primarily used for managing diabetes, in protecting kidney function in patients who've experienced a heart attack. Historically, there has been concern about prescribing SGLT2 inhibitors immediately after a heart attack due to potential kidney risks, especially in unstable patients. However, a comprehensive secondary analysis of the EMPACT-MI trial, published in Nature Cardiovascular Research, provides reassuring evidence that empagliflozin, an SGLT2 inhibitor, can be safely initiated within days after a heart attack. The study involved over 6,500 patients from 22 countries, who started the medication about five days post-hospitalization and were followed for about 18 months.

The findings demonstrated that patients on empagliflozin maintained stable kidney function over two years, with significantly less deterioration compared to those on placebo. Additionally, those receiving empagliflozin experienced a 33% reduction in hospitalizations due to heart failure, regardless of whether they had impaired kidney function at baseline. These results challenge the previous hesitations around prescribing SGLT2 inhibitors post-heart attack and suggest they could be beneficial for broader patient populations.

Lead researcher Dr. Bhatt emphasizes that these drugs are currently underused in clinical practice. The evidence from this large trial indicates that even patients with compromised kidney function can safely benefit from SGLT2 inhibitors after a heart attack, reducing the risk of heart failure without harming renal health. The trial's results are expected to influence future treatment guidelines, encouraging physicians to consider SGLT2 inhibitors more confidently for post-heart attack care.

The EMPACT-MI trial was a randomized, double-blind, placebo-controlled study investigating the effects of empagliflozin on mortality and hospitalization due to heart failure among adults without prior heart failure, regardless of diabetes or kidney disease status. The trial’s significant findings were presented at the American College of Cardiology’s annual session and published in the New England Journal of Medicine. This research marks a major step forward in expanding the use of SGLT2 inhibitors for cardiovascular and renal protection in post-heart attack management.