Empagliflozin Protects Kidneys Post-Acute MI

Empagliflozin has been found to offer protective benefits for the kidneys of patients who have experienced an acute myocardial infarction (MI) and are at a heightened risk for heart failure, according to findings presented at the European Society of Cardiology Congress 2024 in London. The study, led by Dr. Rahul Aggarwal from Harvard Medical School, involved a multicenter trial that included 6,522 patients. These patients were randomly assigned to receive either empagliflozin or a placebo, with the groups stratified based on their baseline estimated glomerular filtration rate (eGFR).

Initially, researchers noted a comparable decline in eGFR at two weeks post-randomization in both groups. The adjusted mean eGFR change from baseline was −4.8 mL/min/1.73 m² for the empagliflozin group and −3.7 mL/min/1.73 m² for the placebo group. However, by the 24-month mark, the eGFR levels in the empagliflozin group had returned to near-baseline levels, while those in the placebo group had significantly decreased. The adjusted mean difference in eGFR change between the groups was 4.1 mL/min/1.73 m², showing a clear benefit for those receiving empagliflozin. This pattern was consistent regardless of whether baseline eGFR was above or below 60 mL/min/1.73 m².

Moreover, the use of empagliflozin led to a reduction in total hospitalizations for heart failure, adverse events related to heart failure or all-cause mortality, and total adverse events of heart failure. The risk ratios for these outcomes were 0.67, 0.79, and 0.63, respectively, indicating a significant protective effect of empagliflozin across different baseline eGFR levels.

Dr. Deepak L. Bhatt from the Mount Sinai Fuster Heart Hospital highlighted in a statement that the data supports the safety of initiating empagliflozin treatment shortly after an acute MI, irrespective of the patient’s baseline kidney function. 

It is also noted that several authors of the study have disclosed financial relationships with biopharmaceutical companies such as Boehringer Ingelheim and Eli Lilly, which are involved in the manufacture of empagliflozin and funded the research.

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