Effects of Empagliflozin on Exercise Capacity Following Acute Myocardial Infarction: Insights from the ELITE-PCI Trial

Andishmand A, Seyedhosaini SM, Haghaninejad H, Zare E and Amel-shahbaz S

Published on: 2025-09-15

Abstract

Background

Exercise capacity is a crucial determinant of prognosis following acute myocardial infarction (AMI). This study aimed to evaluate the impact of empagliflozin on exercise capacity in patients undergoing primary percutaneous coronary intervention (PCI).

Methods

Data from the ELITE-PCI trial were utilized, which enrolled patients diagnosed with AMI who underwent primary PCI between June 8, 2023, and May 25, 2024. Among the 120 enrolled patients, 107 completed the 6-minute walk test (6-MWT), with 54 in the empagliflozin group (10 mg once daily) and 53 in the placebo group.

Results

Baseline characteristics were comparable across the groups, including age (59.4 ± 10.2 vs. 57.3 ± 11.3 years, p=0.325), sex distribution (90.7% vs. 92.5% male, p > 0.999), body mass index (26.4 vs. 26.9 kg/m², p=0.506), glomerular filtration rate (85.5 vs. 85.3 ml/min, p=0.948), and blood pressure readings. No statistically significant differences were observed in 6-MWT distances between the empagliflozin and placebo groups at baseline, after 12 weeks, or in the change in walked distance (Δ walked distance), with p-values exceeding 0.05. Although mean differences indicated a trend toward improvement in the empagliflozin group, these changes did not reach statistical significance. Hierarchical multiple linear regression analysis identified significant independent predictors of the 12-week 6-MWT distance, including baseline 6-MWT distance (p < 0.001), age (p=0.012), left ventricular ejection fraction (LVEF) at 12 weeks (p=0.003), sex (p=0.001), diastolic blood pressure (p=0.013), and history of PCI (p=0.030).

Conclusion

This study did not demonstrate a significant benefit of short-term empagliflozin therapy on exercise capacity in patients undergoing primary PCI.