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Empagliflozin is hypoglycemic drugs. Sodium glucose cotransporter 2 (SGLT-2) is a major transporter that reabsorbes glucose from glomerular filtrate into blood circulation. Enggliptin is a SGLT2 inhibitor, which can reduce the glucose reabsorption of the kidney, reduce the renal glucose threshold, and promote the excretion of glucose from the urine.
  Sodium-glucose co-transport protein 2 inhibitors reduce the risk of hospitalization and death from heart failure in patients with symptomatic heart failure, but there is a lack of trials examining the efficacy of this class of drugs in patients with acute myocardial infarction.
  A trial from Eur Heart J showed a significant improvement in NT-proBNP after 26 weeks in patients on Empagliflozin, and the association was significant. There was also a significant improvement in echocardiographic parameters in patients in the Empagliflozin group.
  (1) This trial was a multicenter, double-blind trial conducted at a teaching hospital.
  (2) Patients with acute myocardial infarction with substantially elevated creatine kinase (n=476) underwent percutaneous coronary intervention for 72 hours and these were randomly assigned to treatment with 10 mg of engramlizine or the corresponding dose of placebo.
  (3) The primary outcome was the change in N-terminal brain natriuretic peptide precursor (NT-proBNP) after 26 weeks. Secondary endpoints included changes in echocardiographic parameters.
  The primary findings were as follows.
  (1) The median baseline NT-proBNP value (interquartile spacing) was 1294 (757-2246) pg/ml.
  (2) After correction for baseline NT-proBNP, gender and prevalence of diabetes (p=0.026), NT-proBNP values decreased by 15% (95% CI -4.4% to -23.6%) in the Empagliflozin group, a significant decrease compared to the placebo group.
  (3) Compared with the placebo group, the absolute left ventricular ejection fraction improved more significantly (1.5%,95%CI 0.2% to 2.9%,p=0.029) and to a greater extent in the Empagliflozin group, with a greater than 6.8% decrease in the mean E/e' ratio (95%CI 1.3% to 11.3%,p=0.015) and a 7.5 ml decrease in left ventricular end-systolic and end-diastolic volumes, respectively ( 95% CI 3.4 ml to 11.5 ml,p=0.0003) and 9.7 ml (95% CI 3.7 ml to 15.7 ml,p=0.0015), respectively.
  (4) Seven patients were admitted to hospital for heart failure (three patients in the Empagliflozin group). Other predetermined serious adverse events were rare and did not differ significantly between groups.
  Conclusion Outlook
  NT-proBNP and echocardiographic parameters were significantly improved in patients with recent myocardial infarction treated with Empagliflozin. The study suggests that Empagliflozin may be used to treat patients with myocardial infarction.

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