Effect of empagliflozin on the heterogeneity of ventricular repolarization in patients with diabetes and coronary artery disease

• Grant number: 18/19511-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): March 01, 2019
• Effective date (End): February 28, 2021
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Bruno Caramelli
• Grantee: Graziella Luciano Antonio
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Cardiovascular diseases are the main cause of morbidity and mortality in diabetic patients. A few years ago, new hypoglycemic drugs are required to undergo cardiovascular safety studies for their release. In 2015 EMPA-REG OUTCOME study, which has approved empagliflozin, a new inhibitor of the type 2 co-transporter for sodium gluconate, was the first study to provide evidence that an antidiabetic agent decreases cardiovascular events. The results showed a reduction in the primary outcome (cardiovascular causes, non-fatal infarction and non-fatal stroke), cardiovascular mortality and hospitalization for heart failure in patients with type 2 diabetes at high cardiovascular risk who received empagliflozin in combination with standard treatment. It is noteworthy that the population under study was under optimal clinical treatment with antihypertensives, statin and aspirin and especially it is noteworthy that the difference in the primary outcome over placebo became evident only 3 months after starting treatment. The potential mechanisms underlying the surprising cardiovascular benefits of empagliflozin are not fully understood. The present project aims to investigate if the empagliflozine displays antiarrhythmic effect. Analyzing the T-wave heterogeneity index, a new electrocardiographic risk marker associated with prediction of cardiovascular risk, in diabetic patients with coronary artery disease, we will verify if empagliflozin is associated with the reduction of electrical instability.