Effect of Empagliflozin Versus Placebo on Body Fluid Balance in Patients With Acute Myocardial Infarction and Type 2 Diabetes Mellitus: Subgroup Analysis of the EMBODY Trial

• Published in: Journal of cardiac failure Vol. 28; no. 1; pp. 56 - 64
• Main Authors: Hoshika, Yu, Kubota, Yoshiaki, Mozawa, Kosuke, Tara, Shuhei, Tokita, Yukichi, Yodogawa, Kenji, Iwasaki, Yu-Ki, Yamamoto, Takeshi, Takano, Hitoshi, Tsukada, Yayoi, Asai, Kuniya, Miyamoto, Masaaki, Miyauchi, Yasushi, Kodani, Eitaro, Maruyama, Mitsunori, Tanabe, Jun, Shimizu, Wataru
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2022
• Subjects: Acute myocardial infarction; Benzhydryl Compounds; bioelectrical impedance analysis; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - drug therapy; Glucosides; Heart Failure - complications; Humans; Myocardial Infarction - complications; Myocardial Infarction - drug therapy; Prospective Studies; sodium-glucose cotransporter 2 inhibitor; Water-Electrolyte Balance; Acute myocardial infarction; sodium-glucose cotransporter 2 inhibitor; bioelectrical impedance analysis
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2021.07.022

•Ethe effect of sodium–glucose cotransporter 2 inhibitors on fluid balance and improvement of heart failure.•Enrolled patients had an acute myocardial infarction and type 2 diabetes mellitus.•Bioelectrical impedance analysis was used to measure extracellular water and intracellular water.•An sodium–glucose cotransporter 2 inhibitor may decrease body weight and attenuate the change in extracellular water and intracellular water.•Results indicate that sodium–glucose cotransporter 2 inhibitors are an effective treatment for heart failure. The development of heart failure is associated with fluid balance, including that of extracellular water (ECW) and intracellular water (ICW). This study determined whether sodium–glucose cotransporter 2 inhibitors affect fluid balance and improve heart failure in patients after acute myocardial infarction. EMBODY was a prospective, randomized, double-blinded, placebo-controlled trial of Japanese patients with acute myocardial infarction and type 2 diabetes. Overall, 55 patients who underwent bioelectrical impedance analysis were randomized to receive once daily 10 mg empagliflozin or placebo 2 weeks after acute myocardial infarction onset. We investigated the time course of body fluid balance measured using the bioelectrical impedance analysis device, InBody. The primary end points were changes in body fluid balance from weeks 0 to 24. Changes between baseline and week 24 in the empagliflozin and placebo groups were –0.21 L (P = .127) and +0.40 L (P = .001) in ECW (P = .001) and –0.23 L (P = .264) and +0.74 L (P < .001) in ICW (P < .001), respectively. In a stratified analysis, the rise in ECW and ICW was significantly attenuated in the empagliflozin group in contrast to the placebo group in participants with a body mass index of 25 or higher but not in those with a body mass index of less than 25. Early sodium–glucose cotransporter 2 inhibitor administration may attenuate changes in ECW and ICW.