Evaluating the effects of empagliflozin in preventing myocardial damage in patients undergoing percutaneous coronary intervention: a double-blind randomized clinical trial

Abstract

Introduction: Percutaneous Coronary Intervention (PCI) is a fundamental procedure for coronary artery disease management, yet the risk of adverse events such periprocedural myocardial injury (PMI) persists. Aim: This double-blind, randomized clinical trial aims to assess the efficacy of empagliflozin in preventing myocardial injury during PCI procedure.Methods: A total of 90 patients were randomly assigned to two groups A and B; Group A as the intervention group received empagliflozin 25 mg 24 hours before and empagliflozin 10 mg 1-2 hours before coronary intervention and group B as the control group received placebo at similar intervals. The primary outcome involved comparing baseline, 8-hour, and 24-hour cTnI and baseline and 24-hour hs-CRP levels after PCI in both groups to measure the incidence of periprocedural myocardial injury (PMI) and anti-inflammatory effects of empagliflozin. Results: Baseline cTnI levels with P = 0.955, 8 hours after PCI with P = 0.469, and 24 hours after the intervention with P = 0.980 were not statistically different in the two groups. Baseline levels of hs-CRP in both intervention and control groups were not statistically significantly different (P = 0.982). Also, there was no statistically significant difference in hs-CRP levels 24 hours after PCI in two groups (P = 0.198). Finally, the results showed that MACEs did not occur in any of the groups.Conclusion: The results of this trial could not express the advantages of acute pretreatment with empagliflozin in preventing PCI-related myocardial injury. Further large clinical trials are recommended to reach a robust evidence regarding empagliflozin in elective PCI.