Could Jardiance Help People Who Have Experienced a Heart Attack?
By April Hopcroft
Many people who experience a heart attack will develop heart failure. In a large clinical trial of adults who had experienced a recent heart attack, Jardiance reduced the risk of hospitalizations for heart failure by 33%.
Jardiance, Farxiga, and other SGLT-2 inhibitors have demonstrated many benefits in addition to improving A1C: namely, slowing kidney disease and protecting against heart failure. The latest data from the EMPACT-MI trial shows that Jardiance’s heart failure benefits may extend to people who have recently experienced a heart attack.
While Jardiance did not significantly lower the risk of a first hospitalization for heart failure or death from any cause, it significantly reduced the risk of hospitalization for heart failure after a heart attack.
These findings are consistent with previous research showing that SGLT-2 inhibitors significantly reduce the risk of hospitalization across the full spectrum of heart failure. Together with other clinical trials for Jardiance, the EMPACT-MI results highlight the value of SGLT-2 inhibitors for addressing cardiometabolic disease – diabetes, heart disease, and kidney disease.
The relationship between heart attacks and heart failure
People with diabetes are twice as likely to have heart disease compared to those without diabetes. Common types of heart disease in people with diabetes include:
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Heart attacks: When blood flow to the heart muscle is blocked by a blood clot.
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Heart failure: When the heart’s pumping action doesn’t work properly.
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Coronary artery disease: When the heart’s arteries narrow or become blocked due to plaque buildup.
According to the British Heart Foundation, up to one-third of people who experienced a heart attack developed heart failure or kidney failure. If a heart attack damages the heart muscle and reduces its ability to pump properly, this can lead to heart failure.
How did the trial work?
The EMPACT-MI trial enrolled 6,522 adults across 22 countries. All participants had experienced a recent heart attack; about one-third also had type 2 diabetes. The majority of participants were white and male, with an average age of 64 years.
Within two weeks of being admitted to the hospital for a heart attack, participants were randomly assigned to one of two treatments to be taken once daily: Jardiance (empagliflozin) 10 mg or a placebo. The study lasted for about a year and a half.
What was the aim of the trial?
Researchers design clinical trials to focus on a specific outcome, known as the primary endpoint. In EMPACT-MI, the primary endpoint was the first hospitalization for heart failure or death from any cause.
Beyond the primary endpoint, the researchers also investigated other outcomes, such as the overall number of hospitalizations.
What were the key findings?
The EMPACT-MI trial did not meet its primary endpoint, meaning that Jardiance failed to significantly reduce the combined outcome of a patient’s first hospitalization for heart failure and death from any cause.
About 8% of participants in the Jardiance group and 9% of participants in the placebo group were hospitalized for heart failure or died from any cause. Because these numbers are so similar, the researchers concluded – via statistical analysis – that Jardiance did not offer a significantly greater benefit compared to placebo on this combined outcome.
However, there were several positive findings:
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Jardiance significantly reduced the risk of a patient’s first hospitalization for heart failure by 23% compared to the placebo group.
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Jardiance significantly reduced the total number of hospitalizations for heart failure by 33%.
Safety-wise, there were no significant differences in the risk of kidney events between groups.
How do these results compare to results of other SGLT-2s?
These findings are very similar to other studies of SGLT-2 inhibitors in people with and without diabetes.
In the DELIVER trial, Farxiga (dapagliflozin) significantly reduced the risk for cardiovascular hospitalization and death by 18% in people with heart failure with or without type 2 diabetes. Based on these results, the FDA approved Farxiga for adults with chronic heart failure.
Additionally, the EMPEROR-Preserved trial showed that Jardiance reduced the risk of hospitalization for heart failure by 29% among people with or without type 2 diabetes. In EMPEROR-Reduced, Jardiance reduced the combined endpoint of time to cardiovascular death or hospitalization for heart failure by 25%. These results led to Jardiance’s initial approval for adults with heart failure.
The bottom line
The EMPACT-MI findings solidify the benefits of SGLT-2 inhibitors in managing heart disease, particularly among people with type 2 diabetes who are at high risk for these complications.
EMPACT-MI is the first to specifically show a benefit of Jardiance after a heart attack, as previous studies have focused on people who have already been diagnosed with heart failure.
These results are especially important because recent data suggests that death due to heart failure is beginning to plateau or even increase after declining in recent decades.
In the past, the FDA has granted additional approvals to Jardiance and other SGLT-2 inhibitors based on new data showing additional benefits. It’s possible that in the future Jardiance could become a recommended treatment for people with diabetes who experience a heart attack.
Learn more about SGLT-2 inhibitors heart health:
