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NCT04509674

EMPACT-MI: A Study to Test Whether Empagliflozin Can Lower the Risk of Heart Failure and Death in People Who Had a Heart Attack (Myocardial Infarction)

Completed Phase 3 Results posted Last updated 7 January 2025
What this trial tests

Phase 3 trial testing Empagliflozin in Myocardial Infarction in 6,522 participants. Completed in 5 November 2023.

Timeline
16 December 2020
Primary endpoint
5 November 2023
5 November 2023

Quick facts

Lead sponsorBoehringer Ingelheim
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment6,522
Start date16 December 2020
Primary completion5 November 2023
Estimated completion5 November 2023
Sites439 locations across Japan, Poland, South Korea, Denmark, Netherlands, Russia, Bulgaria, United States

Drugs / interventions tested

Conditions studied

Sponsor

Boehringer Ingelheim — full company profile →

Who can join

18 and older, any sex, with Myocardial Infarction. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Composite of Time to First Heart Failure Hospitalisation or All-cause Mortality Primary · From randomisation or first study drug administration (if randomisation occurred after first drug administration), until individual day of trial completion. Up to 1004 days.

The composite of time to first heart failure hospitalization or all-cause mortality is reported as the incidence rate of the first occurrence of hospitalization for heart failure (HHF) or death, whichever is earliest. The incidence rate was calculated as: the number of patients with an event for hospitalization for heart failure or death by treatment group during time at risk divided by the total time patients were at risk in that treatment group multiplied by 100 (per 100 Pt-years, Pt as abbreviation of patient).

GroupValue95% CI
Placebo6.585.86 – 7.35
Empagliflozin 10 mg5.855.17 – 6.57
Key Secondary Endpoint - Total Number of Hospitalisations for Heart Failure (HHF) or All-cause Mortality Secondary · From randomisation or first study drug administration (if randomisation occurred after first drug administration), until individual day of trial completion. Up to 1004 days.

The total number of hospitalisations for heart failure (HHF) or all-cause mortality is reported using the adjusted event rate. The adjusted event rate is based on a negative binomial model adjusted for treatment and type-2 diabetes at baseline, geographical region, age at baseline, estimated glomerular filtration rate at baseline, left ventricular ejection fraction at baseline, persistent or permanent atrial fibrillation at baseline, prior myocardial infarction at baseline, peripheral artery disease at baseline and smoking at baseline as covariates. The log(observation time) was used as an of

GroupValue95% CI
Placebo8.256.92 – 9.83
Empagliflozin 10 mg7.145.91 – 8.63
Key Secondary Endpoint - Total Number of Non-elective Cardiovascular (CV) Hospitalisations or All-cause Mortality Secondary · From randomisation or first study drug administration (if randomisation occurred after first drug administration), until individual day of trial completion. Up to 1004 days.

The total number of non-elective cardiovascular (CV) hospitalisations or all-cause mortality is reported using the adjusted event rate. The adjusted event rate is based on a negative binomial model adjusted for treatment and type-2 diabetes at baseline, geographical region, age at baseline, estimated glomerular filtration rate at baseline, left ventricular ejection fraction at baseline, persistent or permanent atrial fibrillation at baseline, prior myocardial infarction at baseline, peripheral artery disease at baseline and smoking at baseline as covariates. The log(observation time) was used

GroupValue95% CI
Placebo16.9015.10 – 18.92
Empagliflozin 10 mg15.5213.82 – 17.43
Key Secondary Endpoint - Total Number of Non-elective All-cause Hospitalisations or All-cause Mortality Secondary · From randomisation or first study drug administration (if randomisation occurred after first drug administration), until individual day of trial completion. Up to 1004 days.

The total number of non-elective all-cause hospitalisations or all-cause mortality is reported using the adjusted event rate. The adjusted event rate is based on a negative binomial model adjusted for treatment and type-2 diabetes at baseline, geographical region, age at baseline, estimated glomerular filtration rate at baseline, left ventricular ejection fraction at baseline, persistent or permanent atrial fibrillation at baseline, prior myocardial infarction at baseline, peripheral artery disease at baseline and smoking at baseline as covariates. The log(observation time) was used as an off

GroupValue95% CI
Placebo26.2823.92 – 28.87
Empagliflozin 10 mg22.9620.84 – 25.31
Key Secondary Endpoint - Total Number of Hospitalisations for Myocardial Infarction (MI) or All-cause Mortality Secondary · From randomisation or first study drug administration (if randomisation occurred after first drug administration), until individual day of trial completion. Up to 1004 days.

The total number of hospitalisations for myocardial infarction (MI) or all-cause mortality is reported using the adjusted event rate. The adjusted event rate is based on a negative binomial model adjusted for factors for treatment and type-2 diabetes at baseline, geographical region, age at baseline, estimated glomerular filtration rate at baseline, left ventricular ejection fraction at baseline, persistent or permanent atrial fibrillation at baseline, prior myocardial infarction at baseline, peripheral artery disease at baseline and smoking at baseline as covariates. The log(observation time

GroupValue95% CI
Placebo6.275.19 – 7.58
Empagliflozin 10 mg6.665.49 – 8.08
Time to Cardiovascular (CV) Mortality Secondary · From randomisation or first study drug administration (if randomisation occurred after first drug administration), until individual day of trial completion. Up to 1004 days.

The time to cardiovascular (CV) mortality is reported as the incidence rate of cardiovascular (CV) mortality, including deaths of unknown cause. The incidence rate was calculated as: the number of patients with a cardiovascular death event by treatment group during time at risk divided by the total time patients were at risk in that treatment group multiplied by 100 (per 100 Pt-years, Pt as abbreviation of patient).

GroupValue95% CI
Placebo2.762.31 – 3.25
Empagliflozin 10 mg2.782.33 – 3.28

Adverse events — posted to ClinicalTrials.gov

Time frame: All-cause mortality - From first drug administration until individual day of trial completion. Up to 1004 days. Adverse event reporting - From first study drug administration to last study drug administration plus 7 days (residual effect period). Up to 1004 days.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Placebo
Serious: 798/3229 (25%)
Deaths: 178/3262
Empagliflozin 10 mg
Serious: 765/3234 (24%)
Deaths: 169/3260

Serious adverse events (490 terms)

ReactionSystemPlaceboEmpagliflozin 10 mg
Cardiac failureCardiac disorders
Myocardial infarctionCardiac disorders
Angina unstableCardiac disorders
Acute kidney injuryRenal and urinary disorders
PneumoniaInfections and infestations
Angina pectorisCardiac disorders
Gastrointestinal haemorrhageGastrointestinal disorders
Non-cardiac chest painGeneral disorders
COVID-19Infections and infestations
Ventricular tachycardiaCardiac disorders
DeathGeneral disorders
SyncopeNervous system disorders
Atrial fibrillationCardiac disorders
Cardiac arrestCardiac disorders
Coronary artery diseaseCardiac disorders
COVID-19 pneumoniaInfections and infestations
Chest painGeneral disorders
Sudden deathGeneral disorders
AnaemiaBlood and lymphatic system disorders
Cardiac ventricular thrombosisCardiac disorders
Ischaemic strokeNervous system disorders
HaematuriaRenal and urinary disorders
Sudden cardiac deathGeneral disorders
Respiratory tract infectionInfections and infestations
Urinary tract infectionInfections and infestations

Most-reported serious reactions: Cardiac failure, Myocardial infarction, Angina unstable, Acute kidney injury, Pneumonia, Angina pectoris, Gastrointestinal haemorrhage, Non-cardiac chest pain.

Data from ClinicalTrials.gov NCT04509674 adverse events section.

Sponsor's own description

This is a study in adults who had a heart attack (myocardial infarction). The purpose of this study is to find out whether a medicine called empagliflozin helps to lower the chances of having to go to the hospital for heart failure and whether it lowers the chances of dying from cardiovascular disease. People who are in hospital may join the study soon after being treated for their heart attack. Participants are put into 2 groups by chance. One group takes 1 empagliflozin tablet a day. The other group takes 1 placebo tablet a day. Placebo tablets look like empagliflozin tablets but do not contain any medicine. All participants continue their standard treatment. Empagliflozin belongs to a class of medicines known as SGLT-2 inhibitors. Empagliflozin is a medicine that helps people with type 2 diabetes to lower their blood sugar. Researchers think that empagliflozin might also help people after heart attack who are at risk for heart failure, whether or not they have diabetes. Participants are in the study for about 1 to 2 years. During this time, there are about 4 visits inperson, 2 visits are done either by phone or by use of an mobile application. Results between the empagliflozin and placebo groups are compared. The doctors also regularly check the general health of the participants.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies.
    Frantz S, Hundertmark MJ, Schulz-Menger J, Bengel FM, et al · · 2022 · cited 401× · PMID 35511857 · DOI 10.1093/eurheartj/ehac223
  2. Empagliflozin in acute myocardial infarction: the EMMY trial.
    von Lewinski D, Kolesnik E, Tripolt NJ, Pferschy PN, et al · · 2022 · cited 213× · PMID 36036746 · DOI 10.1093/eurheartj/ehac494
  3. Empagliflozin after Acute Myocardial Infarction.
    Butler J, Jones WS, Udell JA, Anker SD, et al · · 2024 · cited 208× · PMID 38587237 · DOI 10.1056/nejmoa2314051
  4. Anti-inflammatory role of SGLT2 inhibitors as part of their anti-atherosclerotic activity: Data from basic science and clinical trials.
    Scisciola L, Cataldo V, Taktaz F, Fontanella RA, et al · · 2022 · cited 91× · PMID 36148061 · DOI 10.3389/fcvm.2022.1008922
  5. Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial.
    Hernandez AF, Udell JA, Jones WS, Anker SD, et al · · 2024 · cited 78× · PMID 38581389 · DOI 10.1161/circulationaha.124.069217
  6. SGLT2 inhibitors: from glucose-lowering to cardiovascular benefits.
    Preda A, Montecucco F, Carbone F, Carbone F, et al · · 2024 · cited 76× · PMID 38456601 · DOI 10.1093/cvr/cvae047
  7. Sodium-Glucose Cotransporter-2 Inhibitors After Acute Myocardial Infarction in Patients With Type 2 Diabetes: A Population-Based Investigation.
    Kwon O, Myong JP, Lee Y, Choi YJ, et al · · 2023 · cited 44× · PMID 37421263 · DOI 10.1161/jaha.122.027824
  8. Left Ventricular Function, Congestion, and Effect of Empagliflozin on Heart Failure Risk After Myocardial Infarction.
    Udell JA, Petrie MC, Jones WS, Anker SD, et al · · 2024 · cited 24× · PMID 38588929 · DOI 10.1016/j.jacc.2024.03.405

Verify or expand the search:

Other trials of Empagliflozin

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