心臓発作後の腎機能安定化におけるSGLT2阻害剤エンパグリフロジンの効果(SGLT2 Inhibitor Empagliflozin Treatment Stabilizes Kidney Function in Patients Who Have Had a Heart Attack)

2025-06-13 マウントサイナイ医療システム

<関連情報>

• https://www.mountsinai.org/about/newsroom/2025/sglt2-inhibitor-empagliflozin-treatment-stabilizes-kidney-function-in-patients-who-have-had-a-heart-attack
• https://www.nature.com/articles/s44161-025-00657-7

EMPACT-MI試験の二次解析で急性心筋梗塞後のエンパグリフロジンの心血管・腎臓に対する有効性と安全性が明らかになった Secondary analysis of the EMPACT-MI trial reveals cardiovascular–kidney efficacy and safety of empagliflozin after acute myocardial infarction

Rahul Aggarwal,Deepak L. Bhatt,Adrian F. Hernandez,Stefan D. Anker,Josephine Harrington,W. Schuyler Jones,Michaela Mattheus,Mark C. Petrie,Dominik Steubl,Mikhail Sumin,Vikram Thanam,Jacob A. Udell & Javed Butler
Nature Cardiovascular Research  Published:13 June 2025
DOI:https://doi.org/10.1038/s44161-025-00657-7

Abstract

Data on the cardiovascular–kidney effects and safety of empagliflozin among patients with acute myocardial infarction are limited. EMPACT-MI (Study to Evaluate the Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients with Acute Myocardial Infarction) was a double-blind, multicenter clinical trial that randomized 6,522 patients with acute myocardial infarction and risk for heart failure to empagliflozin or placebo. Here we show in this secondary analysis that the mean estimated glomerular filtration rate at baseline was 76.1 ml min^-1 1.73 m^–2 (s.d. = 19.9 ml min^-1 1.73 m^–2), with longitudinal kidney function data available for 1,152 (17.7%) treated patients from select countries. By 24 months, compared with baseline, the estimated glomerular filtration rate was similar in the empagliflozin group but declined in the placebo group (P = 0.01). Empagliflozin reduced the total adverse events of heart failure or all-cause mortality irrespective of kidney function (P_interaction = 0.30). Thirty-day adverse event rates were similar by treatment group and consistent across baseline kidney function. Empagliflozin had kidney-protective effects, reduced heart failure outcomes and was safe to initiate soon after acute myocardial infarction across baseline kidney function.