Empagliflozin in acute myocardial infarction: the EMMY trial

In chronic heart failure with reduced ejection fraction (HFrEF), sodium–glucose co-transporter 2 inhibitors (SGLT2i) have been shown to reduce the risk of hospitalization for heart failure (HHF) as well as all-cause mortality and cardiovascular mortality.1–4 Recent evidence also indicates beneficial effects of initiating treatment after acute heart failure. In addition, empagliflozin was the first drug shown prospectively in the EMPEROR-Preserved trial to improve the primary outcome of HHF and cardiovascular death in heart failure patients with mildly reduced (HFmrEF) or preserved ejection fraction (HFpEF).The use of SGLT2i for HFrEF was recently recommended in the European and American heart failure guidelines as part of first-line therapy, with the more recent American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Failure Society of America (HFSA) guidelines also advocating SGLT2i use in patients with HFmrEF and HFpEF.

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