Impact of DApagliflozin on Cardiac Functionnfollowing Anterior Myocardial Infarction in Non-diabetic Patients – DACAMI (a Randomized Controlled Clinical Trial)

Abstract

Abstract Background This study aims at identifying if there is a role for Sodium glucose co- transporter 2 inhibitors (SGLT2i) in the event of acute myocardial infarction. Patients who presented with anterior ST- elevation myocardial infarction (STEMI) & had undergone successful primary percutaneous coronary intervention for the left anterior descending coronary were randomized into a study group & a control group. The study group received dapagliflozin 10 mg once daily. The primary endpoint was cardiac function assessed by both; a biomarker (i.e.: N-terminal pro-Brain Natriuretic Peptide – NT-proBNP) measured at baseline & at 12 weeks post the cardiac event & echocardiographic parameters (left ventricular ejection fraction, left ventricular diastolic dimension & left ventricular mass index) assessed at baseline, 4-weeks & 12-weeks post the cardiac event. Results From October 2021 to April 2022, a final 100 patients were randomized. The median drop of NT- proBNP in the study group was significant compared to the control group (p-value 0.043). In addition, the decrease in the left ventricular mass index (LV mass index) was also significant in the study group compared to the control group. Conclusions Dapagliflozin seems to have a role in preventing left ventricular dysfunction & maintaining cardiac function following anterior ST-elevation myocardial infarction. More Large-scale trials need to be done to further confirm these findings. This trial is registered retrospectively at the US National Institutes of Health (ClinicalTrial.gov) with identifier number: NCT05424315 – June 16th, 2022. (https://ClinicalTrials.gov/ct2/show/nct05424315)