Umaña Mejia Carlos A, Flores Valdés Jose R, Alvarado Corletto Dominique, Trujillo Asturias Milton A, Rojo Mendoza Alfredo I, Razo Paulina, Castillo Jaqueline L, Alvarez Flores Diana R, Garcia-Vasquez Edwin A, López Hernández Luis F
General Medicine, Universidad Autonoma De Guadalajara, Guadalajara, MEX.
General Physician, Memorial Hermann Health System, Houston, USA.
Cureus. 2025 Jul 5;17(7):e87354. doi: 10.7759/cureus.87354. eCollection 2025 Jul.
Empagliflozin, a sodium-glucose cotransporter-2 inhibitor (SGLT2), is well-established for managing various cardio-renal conditions, but its effectiveness in patients recovering from acute myocardial infarction (AMI) remains unclear. This systematic review aims to evaluate whether empagliflozin reduces mortality and hospitalization rates compared to placebo in this population. We identified five randomized controlled trials (RCTs) from PubMed and ScienceDirect up to May 2024, which compared empagliflozin to placebo in patients with recent AMI. A total of 7229 participants were included. The primary outcomes were reductions in mortality and hospitalization rates, while secondary outcomes included changes in N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and left ventricular ejection fraction (LVEF). Empagliflozin did not significantly reduce cardiovascular mortality or hospitalization rates. However, some studies reported a statistically significant reduction in NT-proBNP levels of up to 15% in the empagliflozin group. Additionally, a 1.5% greater increase in LVEF was observed in patients treated with empagliflozin compared to placebo in certain studies. Although empagliflozin has a favorable safety profile and shows positive effects on biomarkers related to heart failure (HF), current evidence does not support its use as an effective intervention for reducing mortality or hospitalizations in AMI patients. Further research is needed to confirm its efficacy in this population.
恩格列净是一种钠-葡萄糖协同转运蛋白2抑制剂（SGLT2），在治疗各种心肾疾病方面已得到充分证实，但其在急性心肌梗死（AMI）康复患者中的有效性仍不明确。本系统评价旨在评估与安慰剂相比，恩格列净在该人群中是否能降低死亡率和住院率。我们从PubMed和ScienceDirect数据库中检索到截至2024年5月的五项随机对照试验（RCT），这些试验比较了恩格列净与安慰剂在近期AMI患者中的疗效。共纳入7229名参与者。主要结局是死亡率和住院率的降低，次要结局包括N末端脑钠肽前体（NT-proBNP）水平和左心室射血分数（LVEF）的变化。恩格列净并未显著降低心血管死亡率或住院率。然而，一些研究报告称，恩格列净组的NT-proBNP水平在统计学上显著降低了高达15%。此外，在某些研究中，与安慰剂相比，接受恩格列净治疗的患者LVEF增加幅度高1.5%。尽管恩格列净具有良好的安全性，并且对与心力衰竭（HF）相关的生物标志物显示出积极作用，但目前的证据并不支持将其作为降低AMI患者死亡率或住院率的有效干预措施。需要进一步研究来证实其在该人群中的疗效。
