Alterations in trimethylamine-N-oxide in response to Empagliflozin therapy: a secondary analysis of the EMMY trial
Authors' conclusion
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.
Study context
- Population
- Patients after acute MI; mean age 57 ± 9 years, 82% males, 14% T2D
- Participants
- 367 patients
- Comparison
- Empagliflozin vs placebo for 26 weeks after acute myocardial infarction (AMI)
- Primary endpoint
- Change in serum TMAO levels
- Follow-up
- 6 and 26 weeks
Methodological detailsplacebo-controlled
- Placebo-controlled
Primary result
As reported in the abstract
Serum TMAO · 26 weeks
P for interaction = 0.007
- Serum TMAO increase, baseline to week 6 (coefficient)
- 0.233; 95% CI 0.149-0.317, p < 0.001
- Serum TMAO increase, baseline to week 26 (coefficient)
- 0.320, 0.236-0.405, p < 0.001
Further findings
Serum TMAO at baseline
Serum TMAO at 6 weeks
Associations with TMAO
- Age positively associated with TMAO; eGFR and LVEF negatively associated
Original publication
Alterations in trimethylamine-N-oxide in response to Empagliflozin therapy: a secondary analysis of the EMMY trial. Cardiovasc Diabetol. Published 20 July 2023. doi:10.
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