Empagliflozin and left ventricular diastolic function following an acute coronary syndrome in patients with type 2 diabe
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ORIGINAL PAPER
Empagliflozin and left ventricular diastolic function following an acute coronary syndrome in patients with type 2 diabetes Nick S. R. Lan1,2 · Bu B. Yeap2,3 · P. Gerry Fegan2,4 · Gillian Green1 · James M. Rankin1 · Girish Dwivedi1,3,5 Received: 9 July 2020 / Accepted: 18 September 2020 © Springer Nature B.V. 2020
Abstract Sodium-glucose cotransporter 2 inhibitors can improve heart failure outcomes, however, the effects on left ventricular (LV) function remain unclear. This prospective observational study aimed to investigate whether initiating empagliflozin therapy was associated with improved LV diastolic function following an acute coronary syndrome (ACS) in patients with type 2 diabetes (T2D). Patients with ACS and T2D were identified during hospitalisation in a cardiology unit. Empagliflozin was initiated at discharge in eligible patients (i.e. HbA1c > 7%) without contraindications or precautions. Transthoracic echocardiography was performed during admission and after 3–6 months. Changes in echocardiographic parameters were compared between patients initiated on empagliflozin versus not initiated on empagliflozin (control). There were 22 patients in each group (n = 44). Baseline characteristics, medications and echocardiographic parameters were similar except HbA1c (empagliflozin: 9.8 ± 1.6% versus control: 6.6 ± 0.7%, p 6.5% or > 48 mmol/mol] or pre-diabetes (we used HbA1c 6.1–6.5% or 43–48 mmol/ mol) during admission [21]. Exclusion criteria included SGLT2 inhibitor or glucagon-like peptide-1 agonist use within the last 12 months, age 80 years, history of diabetic ketoacidosis, type 1 diabetes, atrial fibrillation, moderate or severe valvular heart disease, previous valve surgery, estimated glomerular filtration rate (eGFR)
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