Effect of Dapagliflozin Administration on the Apoptosis Levels of Patients With Acute Myocardial Infarction

The study is a randomized controlled trial, single-center study in Acute Myocardial Infarction (AMI) patients held in Moewardi General Hospital, Central Java, Indonesia. The investigator divided 40 patients with AMI into two groups, the first is the Dapagliflozin group, which will get 10mg of Dapagliflozin once a day every morning and the second group will have a placebo once a day every morning also for 14 days. Each patient will be checked for Caspase-3 level from blood serum as primary outcome and Global Work (GW) echocardiographic parameters such as GWI, GCW, GWW, and GWE as secondary outcome at admission and 14 days after intervention. The study was approved by the hospital ethics committee. The clinical parameters above will then be analyzed. To determine the mean difference between unpaired groups (treatment and control), an independent T-test is used if the distribution is normal (if not, the Mann-Whitney test is used). Normality testing is performed using the Shapiro-Wilk test, considering the sample size is less than 50.

Inclusion criteria

• Patients with Acute Myocardial Infarction (STEMI or NSTEMI) according to the Fourth Universal Definition of Myocardial Infarction from the European Society of Cardiology, American College of Cardiology, American Heart Association, and World Heart Federation.
• Aged 18-75 years
• Willing to participate in the study and sign informed consent.

Exclusion criteria

• Patients with cardiogenic shock (SBP ≤ 80 mmHg, cold extremities, urine output <0.5 ml/kg/hr) <24 hours before randomization
• Patients with ketoacidosis (arterial pH <7.30, serum bicarbonate <18 mEq/l, positive ketonuria)
• Patients with impaired renal function with an estimated glomerular filtration rate (eGFR) <20 ml/min or requiring dialysis
• Patients with a history of chronic heart failure before the onset of Acute Myocardial Infarction
• Patients scheduled for coronary artery bypass surgery
• Patients with type 1 diabetes mellitus
• Patients with severe valvular disease
• Patients with sepsis
• Patients with symptomatic acute urinary tract infection
• Pregnant patients
• Patients with severe aortic stenosis or LVOT obstruction