Acute Coronary Syndrome. Acute coronary microvascular dysfunction
Conditions
Interventions
Intervention 1: Intervention group: Participants in this group will receive a once-daily oral dose of 10 milligrams of empagliflozin following the diagnosis of acute coronary syndrome. The medication
empagliflozin will be added to the standard regimen. Intervention 2: Control group: Participants in this group will receive standard care for type 2 diabetes mellitus and acute coronary syndrome witho
Sponsors
Ahvaz University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Inclusion criteria
Inclusion criteria: Patients aged over 18 years with confirmed type 2 diabetes mellitus Patients admitted with a recent diagnosis of acute coronary syndrome (ACS) Left ventricular ejection fraction (LVEF) between 30% and 45% Confirmed left atrial dysfunction based on echocardiography Eligibility to receive SGLT2 inhibitors based on clinical judgment Hemodynamic stability after ACS diagnosis HbA1c equal to or greater than 6.5% or fasting plasma glucose over 126 mg/dL Written informed consent provided by the patient No prior treatment with SGLT2 inhibitors No history of drug intolerance to SGLT2 inhibitors
Exclusion criteria
Exclusion criteria: Estimated glomerular filtration rate (eGFR) less than 20 mL/min/1.73m2 History of recurrent urinary tract infections (UTIs) End-stage renal disease (ESRD) patients receiving dialysis Confirmed valvular heart disease Severe liver failure Advanced heart failure with NYHA class IV Current treatment with SGLT2 inhibitors Known intolerance or hypersensitivity to SGLT2 inhibitors Concurrent inflammatory diseases such as active infection, pyelonephritis, urosepsis, or sepsis Diabetic ketoacidosis (DKA) at the time of enrollment Refusal to participate or not signing informed consent form
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Left Atrial Strain, as a functional parameter of the left atrium, measured using speckle-tracking echocardiography at baseline and after six months; includes reservoir strain, conduit strain, and booster pump strain, each assessed separately. Timepoint: Measurement of left atrial strain at the beginning of the study (prior to intervention) and at the end of week twenty-four (six months after the start of intervention). Method of measurement: Left atrial strain will be measured using speckle-tracking echocardiography with two-dimensional imaging from apical four-chamber and two-chamber views; images will be acquired with an advanced echocardiography device (GE Vivid E95) and analyzed using dedicated strain analysis software in a specialized core lab. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactMohammad Javad Mohammad Taghizadeh
Ahvaz University of Medical Sciences
Outcome results
None listed