SGLT2 Inhibitor on Infarct Size and LV Remodeling by CMR in Patients With AMI.
A heart-protective diabetes drug did not reduce heart damage in acute heart attack patients, refocusing research on when and how SGLT2 inhibitors truly benefit the heart.
The PRESTIGE-AMI RCT randomized 200 AMI patients at high heart failure risk to empagliflozin 10 mg or standard care after successful PCI; CMR was performed at baseline and 6 months in 169 patients. Both the primary endpoint (infarct size by % LV mass) and co-primary endpoint (delta LV end-systolic volume) showed no significant between-group differences, providing definitive evidence that SGLT2 inhibitors do not confer acute myocardial protection or promote mechanical remodeling in the peri-infarct period.
What the study was
- Study design
- randomized_controlled_trial
- Population
- AMI patients at high heart failure risk after successful PCI (n=200, PRESTIGE-AMI trial)
- Sample size
- 200
- Category
- Treatment Innovation
- Maturity
- Validated
- Journal
- JACC Cardiovasc Interv
Why it surfaced
Definitive RCT (JACC Cardiovasc Interv, n=200, CMR-validated) showing SGLT2 inhibitors do not reduce infarct size or promote LV remodeling post-AMI—a high-value negative result that clarifies the mechanism of SGLT2 cardioprotective benefit (not via ischemic salvage) and informs design of future acute cardiac intervention trials.
A plain-language summary of published research — not medical advice. Talk to a clinician about your own care.