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.
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