Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Aziz, F; Tripolt, NJ; Pferschy, PN; Kolesnik, E; Mangge, H; Curcic, P; Hermann, M; Meinitzer, A; von, Lewinski, D; Sourij, H, , EMMY, Investigators.
Alterations in trimethylamine-N-oxide in response to Empagliflozin therapy: a secondary analysis of the EMMY trial.
Cardiovasc Diabetol. 2023; 22(1): 184
Doi: 10.1186/s12933-023-01920-6
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- Führende Autor*innen der Med Uni Graz
- Aziz Faisal
- Sourij Harald
- von Lewinski Dirk
- Co-Autor*innen der Med Uni Graz
- Curcic Pero
- Mangge Harald
- Meinitzer Andreas
- Pferschy Peter
- Tripolt Norbert
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- Abstract:
- INTRODUCTION: The relationship between sodium glucose co-transporter 2 inhibitors (SGLT2i) and trimethylamine N-oxide (TMAO) following acute myocardial infarction (AMI) is not yet explored. METHODS: In this secondary analysis of the EMMY trial (ClinicalTrials.gov registration: NCT03087773), changes in serum TMAO levels were investigated in response to 26-week Empagliflozin treatment following an AMI compared to the standard post-MI treatment. Additionally, the association of TMAO changes with clinical risk factors and cardiorenal biomarkers was assessed. RESULTS: The mean age of patients (N = 367) was 57 ± 9 years, 82% were males, and 14% had type 2 diabetes. In the Empagliflozin group, the median TMAO value was 2.62 µmol/L (IQR: 1.81) at baseline, 3.74 µmol/L (2.81) at 6 weeks, and 4.20 µmol/L (3.14) at 26 weeks. In the placebo group, the median TMAO value was 2.90 µmol/L (2.17) at baseline, 3.23 µmol/L (1.90) at 6 weeks, and 3.35 µmol/L (2.50) at 26 weeks. The serum TMAO levels increased significantly from baseline to week 6 (coefficient: 0.233; 95% confidence interval 0.149-0.317, p < 0.001) and week 26 (0.320, 0.236-0.405, p < 0.001). The average increase in TMAO levels over time (pinteraction = 0.007) was significantly higher in the Empagliflozin compared to the Placebo group. Age was positively associated with TMAO, whereas eGFR and LVEF were negatively associated with TMAO. CONCLUSIONS: Our results are contrary to existing experimental studies that showed the positive impact of SGLT2i on TMAO precursors and cardiovascular events. Therefore, we recommend further research investigating the impact of SGLT2i therapy on acute and long-term changes in TMAO in cardiovascular cohorts.
- Find related publications in this database (using NLM MeSH Indexing)
- Male - administration & dosage
- Humans - administration & dosage
- Middle Aged - administration & dosage
- Aged - administration & dosage
- Female - administration & dosage
- Diabetes Mellitus, Type 2 - diagnosis, drug therapy, epidemiology
- Myocardial Infarction - complications
- Sodium-Glucose Transporter 2 Inhibitors - adverse effects
- Oxides - administration & dosage
- Find related publications in this database (Keywords)
- Clinical trial
- RCT
- Empagliflozin
- Heart failure
- Myocardial infarction
- Trimethylamine N-oxide