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CompletedNCT05335629Updated Feb 1, 2024

Evaluation of the Effect of SGLT-2 Inhibitors on Cardiac Remodeling in Post Myocardial Infarction Patients

An interventional study of Dapagliflozin 10Mg Tab in Myocardial Infarction, Diabetes Mellitus, Type 2 and Myocardial Remodeling, Ventricular, sponsored by Ain Shams University. Completed at 1 site in Egypt. Open to participants aged 18 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-02-01.

Sponsored by Ain Shams University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
54
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

A prospective, randomized, controlled study will be conducted at Clinical Cardioglogy department, Ain Shams University Hospitals, assessing the efficacy and tolerability of SGLT2 inhibitors (dapagliflozin) addition on the clinical outcome and cardiac remodeling markers of post myocardial infarction (MI) diabetic patients

Read the detailed description

All patients presenting to the Clinical Cardiology department, Ain Shams University Hospitals, will be assessed for eligibility as follow:

Inclusion criteria:

  1. Female or male aged >18 and \< 75 years
  2. Diabetic post myocardial infarction patients
  3. First anterior STEMI with successful TIMI-3 flow
  4. STEMI within 12 hrs of onset of chest pain
  5. creatine clearance ≥60 mL/min
  6. HbA1c between 6.5% and 12.0%

Exclusion criteria:

  1. Cardiogenic shock on admission
  2. Multivessel disease on admission
  3. Mechanical complications e.g. mitral regurge on admission
  4. Life threatening arrhythmia on admission
  5. Hemodynamic instability on admission
  6. Diagnosis of Type 1 diabetes mellitus
  7. History of bladder cancer or history of radiation therapy to the lower abdomen or pelvis at any time
  8. Active urinary infection diagnosed by clinical symptoms of urgency and frequency + lab tests
  9. Pregnant or breast-feeding patients
  10. Active participation in another clinical study
  11. AST or ALT >3x ULN or Total bilirubin >2.5 x ULN
  12. CrCl \< 60 ml/min (based on the Cockroft-Gault equation)

Eligible patients will be randomly assigned into one of 2 arms:

  1. Group 1 (Healthy control) (n=10) Aged-matched healthy volunteers who do not suffer any diseases.
  2. Group 2 (Control group) (n= 30): Post-MI patients who will receive standard of care for 4 Weeks
  3. Group 3 (Test group) (n= 30): Post-MI patients who will receive standard of care in addition to the SGLT2 Dapagliflozin 10 mg daily for 4 Weeks

    • Dapagliflozin will be administered immediately at time of PCI and daily for 4 weeks.
    • Standard of care will given to both arms (group 2 and 3) and includes:

Dual Antiplatelet Therapy (DAPT), high intensity statin, anticoagulation therapy, ACEI or aldosterone antagonist depending on the ejection fraction

  • All subjects will sign an informed consent statement prior to inclusion in the study.
  • All subjects will be followed up for 4 weeks and blood samples will be withdrawn at baseline, 1 week, and the end of the study to test for ST2 (suppression of tumerogenicity 2) biomarker
02

Conditions studied

  • Myocardial Infarction
  • Diabetes Mellitus, Type 2
  • Myocardial Remodeling, Ventricular

Keywords

  • Dapagliflozin
  • ST2
  • Myocardial infarction
  • Cardiac remodeling
  • T2DM
03

In context

Myocardial Infarction

2,744 studies on the registry are indexed under Myocardial Infarction; 418 are open to participants now.

This study's enrollment of 54 is below the median of 148 across 1,595 interventional studies indexed under Myocardial Infarction.

Browse Myocardial Infarction studies →

Lead sponsor

Ain Shams University is the lead sponsor of 1,876 studies on the registry; 423 are open to participants now.

Of its 32 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Female or male aged >18 and \< 75 years
  2. Diabetic post myocardial infarction patients
  3. First anterior STEMI with successful TIMI-3 flow
  4. STEMI within 12 hrs of onset of chest pain
  5. creatine clearance ≥60 mL/min
  6. HbA1c between 6.5% and 12.0%

Exclusion criteria

Exclusion Criteria:

  1. Cardiogenic shock on admission
  2. Multivessel disease on admission
  3. Mechanical complications e.g. mitral regurge on admission
  4. Life threatening arrhythmia on admission
  5. Hemodynamic instability on admission
  6. Diagnosis of Type 1 diabetes mellitus
  7. History of bladder cancer or history of radiation therapy to the lower abdomen or pelvis at any time
  8. Active urinary infection diagnosed by clinical symptoms of urgency and frequency + lab tests
  9. Pregnant or breast-feeding patients
  10. Active participation in another clinical study
  11. AST or ALT >3x ULN or Total bilirubin >2.5 x ULN
  12. CrCl \< 60 ml/min (based on the Cockroft-Gault equation)
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
54 participants (actual)

Study arms

  • Active comparator
    Intervention arm

    30 patients will receive standard of care in addition to the SGLT2 Dapagliflozin 10 mg daily for 4 Weeks Interventions: Drug: Dapagliflozin 10 mg oral tablets Standard of care: Dual antiplatelet therapy, Statin, anticoagulation therapy

    Drug: Dapagliflozin 10Mg Tab

  • No intervention
    Control arm

    30 patients will receive standard of care (Dual antiplatelet therapy, Statin, anticoagulation therapy) for 4 weeks

Interventions

  • DrugDapagliflozin 10Mg Tab

    Dapagliflozin is a sodium-glucose cotransporter-2 inhibitor (SGLT2 inhibitor) which is a new class of hypoglycemic drugs, and they can block sodium-dependent glucose transporter-2 (SGLT2) located in the early proximal renal tubule to increase urinary glucose excretion and decrease the concentration of blood glucose

06

What researchers measure

Primary outcomes

  1. Effect on ST2 (suppression of tumerogenicity 2) level in the acute phase after myocardial infarction

    patients will be followed up for the whole period of the study and blood sample will be drawn at baseline and at study end to track changes in the level of ST2 (suppression of tumerogenicity 2) which is a cardiac remodeling biomarker using ELISA technique

    Time frame: 4 weeks

Secondary outcomes

  1. Echocardiographic changes due to intervention

    patients will have their echocardiography and ejection fraction will be compared at baseline and at the end of the study to track any changes that may be caused by intervention

    Time frame: 4 weeks

07

Study locations

1 site
  • Ain shams university hospitals
    Cairo, Egypt
08

References and documents

Publications

  • Baker ML, Perazella MA. SGLT2 inhibitor therapy in patients with type-2 diabetes mellitus: is acute kidney injury a concern? J Nephrol. 2020 Oct;33(5):985-994. doi: 10.1007/s40620-020-00712-5. Epub 2020 Feb 18. PubMed 32067179 ↗
  • Berezin AE, Berezin AA. Adverse Cardiac Remodelling after Acute Myocardial Infarction: Old and New Biomarkers. Dis Markers. 2020 Jun 12;2020:1215802. doi: 10.1155/2020/1215802. eCollection 2020. PubMed 32626540 ↗
  • Bolognese L, Falsini G, Schwenke C, Grotti S, Limbruno U, Liistro F, Carrera A, Angioli P, Picchi A, Ducci K, Pierli C. Impact of iso-osmolar versus low-osmolar contrast agents on contrast-induced nephropathy and tissue reperfusion in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (from the Contrast Media and Nephrotoxicity Following Primary Angioplasty for Acute Myocardial Infarction [CONTRAST-AMI] Trial). Am J Cardiol. 2012 Jan 1;109(1):67-74. doi: 10.1016/j.amjcard.2011.08.006. Epub 2011 Sep 22. PubMed 21943940 ↗
  • Broch K, Andreassen AK, Ueland T, Michelsen AE, Stueflotten W, Aukrust P, Aakhus S, Gullestad L. Soluble ST2 reflects hemodynamic stress in non-ischemic heart failure. Int J Cardiol. 2015 Jan 20;179:378-84. doi: 10.1016/j.ijcard.2014.11.003. Epub 2014 Nov 5. PubMed 25464491 ↗
  • Brown AJM, Gandy S, McCrimmon R, Houston JG, Struthers AD, Lang CC. A randomized controlled trial of dapagliflozin on left ventricular hypertrophy in people with type two diabetes: the DAPA-LVH trial. Eur Heart J. 2020 Sep 21;41(36):3421-3432. doi: 10.1093/eurheartj/ehaa419. PubMed 32578850 ↗
  • Gruzdeva O, Dyleva Y, Uchasova E, Akbasheva O, Karetnikova V, Kashtalap V, Shilov A, Polikutina O, Slepynina Y, Barbarash O. Biological markers and cardiac remodelling following the myocardial infarction. Aging (Albany NY). 2019 Jun 10;11(11):3523-3535. doi: 10.18632/aging.101994. PubMed 31182683 ↗
  • Iwahana H, Yanagisawa K, Ito-Kosaka A, Kuroiwa K, Tago K, Komatsu N, Katashima R, Itakura M, Tominaga S. Different promoter usage and multiple transcription initiation sites of the interleukin-1 receptor-related human ST2 gene in UT-7 and TM12 cells. Eur J Biochem. 1999 Sep;264(2):397-406. doi: 10.1046/j.1432-1327.1999.00615.x. PubMed 10491084 ↗
  • Januzzi JL Jr, Peacock WF, Maisel AS, Chae CU, Jesse RL, Baggish AL, O'Donoghue M, Sakhuja R, Chen AA, van Kimmenade RR, Lewandrowski KB, Lloyd-Jones DM, Wu AH. Measurement of the interleukin family member ST2 in patients with acute dyspnea: results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study. J Am Coll Cardiol. 2007 Aug 14;50(7):607-13. doi: 10.1016/j.jacc.2007.05.014. Epub 2007 Jul 30. PubMed 17692745 ↗
  • Kokkoz C, Bilge A, Irik M, Dayangac HI, Hayran M, Akarca FK, Erdem NB, Cavus M. Prognostic value of plasma ST2 in patients with non-ST segment elevation acute coronary syndrome. Turk J Emerg Med. 2018 Feb 9;18(2):62-66. doi: 10.1016/j.tjem.2018.01.003. eCollection 2018 Jun. PubMed 29922732 ↗
  • Lam CSP, Chandramouli C, Ahooja V, Verma S. SGLT-2 Inhibitors in Heart Failure: Current Management, Unmet Needs, and Therapeutic Prospects. J Am Heart Assoc. 2019 Oct 15;8(20):e013389. doi: 10.1161/JAHA.119.013389. Epub 2019 Oct 12. No abstract available. PubMed 31607208 ↗
  • Li C, Zhang J, Xue M, Li X, Han F, Liu X, Xu L, Lu Y, Cheng Y, Li T, Yu X, Sun B, Chen L. SGLT2 inhibition with empagliflozin attenuates myocardial oxidative stress and fibrosis in diabetic mice heart. Cardiovasc Diabetol. 2019 Feb 2;18(1):15. doi: 10.1186/s12933-019-0816-2. PubMed 30710997 ↗
  • Ma ZG, Yuan YP, Wu HM, Zhang X, Tang QZ. Cardiac fibrosis: new insights into the pathogenesis. Int J Biol Sci. 2018 Sep 7;14(12):1645-1657. doi: 10.7150/ijbs.28103. eCollection 2018. PubMed 30416379 ↗
  • Mancini GB, Dahlof B, Diez J. Surrogate markers for cardiovascular disease: structural markers. Circulation. 2004 Jun 29;109(25 Suppl 1):IV22-30. doi: 10.1161/01.CIR.0000133443.77237.2f. No abstract available. PubMed 15226248 ↗
  • McCarthy CP, Januzzi JL Jr. Soluble ST2 in Heart Failure. Heart Fail Clin. 2018 Jan;14(1):41-48. doi: 10.1016/j.hfc.2017.08.005. PubMed 29153199 ↗
  • Millar NL, O'Donnell C, McInnes IB, Brint E. Wounds that heal and wounds that don't - The role of the IL-33/ST2 pathway in tissue repair and tumorigenesis. Semin Cell Dev Biol. 2017 Jan;61:41-50. doi: 10.1016/j.semcdb.2016.08.007. Epub 2016 Aug 10. PubMed 27521518 ↗
  • Sanada S, Hakuno D, Higgins LJ, Schreiter ER, McKenzie AN, Lee RT. IL-33 and ST2 comprise a critical biomechanically induced and cardioprotective signaling system. J Clin Invest. 2007 Jun;117(6):1538-49. doi: 10.1172/JCI30634. Epub 2007 May 10. PubMed 17492053 ↗
  • Santos-Gallego CG, Requena-Ibanez JA, San Antonio R, Ishikawa K, Watanabe S, Picatoste B, Flores E, Garcia-Ropero A, Sanz J, Hajjar RJ, Fuster V, Badimon JJ. Empagliflozin Ameliorates Adverse Left Ventricular Remodeling in Nondiabetic Heart Failure by Enhancing Myocardial Energetics. J Am Coll Cardiol. 2019 Apr 23;73(15):1931-1944. doi: 10.1016/j.jacc.2019.01.056. PubMed 30999996 ↗
  • Schmitz J, Owyang A, Oldham E, Song Y, Murphy E, McClanahan TK, Zurawski G, Moshrefi M, Qin J, Li X, Gorman DM, Bazan JF, Kastelein RA. IL-33, an interleukin-1-like cytokine that signals via the IL-1 receptor-related protein ST2 and induces T helper type 2-associated cytokines. Immunity. 2005 Nov;23(5):479-90. doi: 10.1016/j.immuni.2005.09.015. PubMed 16286016 ↗
  • Smith JN, Negrelli JM, Manek MB, Hawes EM, Viera AJ. Diagnosis and management of acute coronary syndrome: an evidence-based update. J Am Board Fam Med. 2015 Mar-Apr;28(2):283-93. doi: 10.3122/jabfm.2015.02.140189. PubMed 25748771 ↗
  • Teh PP, Vasanthakumar A, Kallies A. Development and Function of Effector Regulatory T Cells. Prog Mol Biol Transl Sci. 2015;136:155-74. doi: 10.1016/bs.pmbts.2015.08.005. Epub 2015 Sep 26. PubMed 26615096 ↗
  • Tominaga S. A putative protein of a growth specific cDNA from BALB/c-3T3 cells is highly similar to the extracellular portion of mouse interleukin 1 receptor. FEBS Lett. 1989 Dec 4;258(2):301-4. doi: 10.1016/0014-5793(89)81679-5. PubMed 2532153 ↗
  • Trajkovic V, Sweet MJ, Xu D. T1/ST2--an IL-1 receptor-like modulator of immune responses. Cytokine Growth Factor Rev. 2004 Apr-Jun;15(2-3):87-95. doi: 10.1016/j.cytogfr.2004.02.004. PubMed 15110792 ↗
  • Tseng CCS, Huibers MMH, van Kuik J, de Weger RA, Vink A, de Jonge N. The Interleukin-33/ST2 Pathway Is Expressed in the Failing Human Heart and Associated with Pro-fibrotic Remodeling of the Myocardium. J Cardiovasc Transl Res. 2018 Feb;11(1):15-21. doi: 10.1007/s12265-017-9775-8. Epub 2017 Dec 28. PubMed 29285671 ↗
  • Veeraveedu PT, Sanada S, Okuda K, Fu HY, Matsuzaki T, Araki R, Yamato M, Yasuda K, Sakata Y, Yoshimoto T, Minamino T. Ablation of IL-33 gene exacerbate myocardial remodeling in mice with heart failure induced by mechanical stress. Biochem Pharmacol. 2017 Aug 15;138:73-80. doi: 10.1016/j.bcp.2017.04.022. Epub 2017 Apr 25. PubMed 28450225 ↗
  • Weinberg EO, Shimpo M, De Keulenaer GW, MacGillivray C, Tominaga S, Solomon SD, Rouleau JL, Lee RT. Expression and regulation of ST2, an interleukin-1 receptor family member, in cardiomyocytes and myocardial infarction. Circulation. 2002 Dec 3;106(23):2961-6. doi: 10.1161/01.cir.0000038705.69871.d9. PubMed 12460879 ↗
  • Wojcik C, Warden BA. Mechanisms and Evidence for Heart Failure Benefits from SGLT2 Inhibitors. Curr Cardiol Rep. 2019 Sep 14;21(10):130. doi: 10.1007/s11886-019-1219-4. PubMed 31522263 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 1, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05335629
Lead sponsor
Ain Shams University
Responsible party
Abdallah Heshmat (Clinical pharmacy demonstrator, Ain Shams University) — Principal investigator
First posted
Apr 19, 2022
Start date
Jun 1, 2022
Primary completion
Oct 1, 2023
Completion
Oct 1, 2023
Last update
Feb 1, 2024

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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