Key result
Dapagliflozin cuts serum caspase-3 levels ~43% vs placebo at 14 days post-MI.
Why the study?
Human studies evaluating the effects of dapagliflozin on caspase-3 levels and myocardial work in AMI patients were not yet available.
Does dapagliflozin reduce serum caspase-3 levels and improve myocardial work in patients with acute myocardial infarction?
RCT (n=40)
Double-blind
Simple randomization with 1:1 allocation
No
Does dapagliflozin reduce serum caspase-3 levels and improve myocardial work in patients with acute myocardial infarction?
Absolute Event Rate: 29.55% vs 51.97%
p-value: p=0.007
Early administration of dapagliflozin in patients with acute myocardial infarction significantly reduced serum caspase-3 levels, a key marker of apoptosis, though it did not lead to early significant improvements in echocardiographic myocardial work indices at 14 days.
Dapagliflozin reduces caspase-3 post-MI; confirms anti-apoptotic effects in patients and supports larger outcome trials.
Background: Acute myocardial infarction (AMI) is a common cardiovascular disease and a leading cause of morbidity and mortality. Cellular death during AMI involves apoptosis (80%) and necrosis (20%). Apoptosis contributes to infarct size, Left Ventricular (LV) remodeling, and heart failure post-AMI. Previous studies suggest that dapagliflozin can reduce myocardial apoptosis, marked by decreased caspase-3 levels (preclinical study) and echocardiographic parameters (preclinical and clinical studies). However, human studies evaluating the effects of dapagliflozin on caspase-3 and myocardial work (MW) in AMI patients are not yet available. This study aims to evaluate the effect of dapagliflozin administration on caspase-3 levels and MW in AMI patients. Methods: This was a single-center experimental study with a double-blind randomized controlled trial (RCT) design conducted among 40 AMI patients at Dr. Moewardi General Hospital, Surakarta (September–November 2024). Patients were divided into two groups: dapagliflozin and placebo. Caspase-3 levels and MW parameters (Global Work Index [GWI], Global Constructive Work [GCW], Global Wasted Work [GWW], Global Work Efficiency [GWE]) were measured at admission before and on day 14 post-treatment. Statistical analysis was performed using independent t-tests or Mann-Whitney tests, with p < 0.05 considered significant. Results: The mean pre-test caspase-3 levels were not significantly different between the intervention group, 51.05±36.53ng/ml, and the control group, 56.44±31.01ng/ml (p=0.618). However, post-test caspase-3 levels showed a significant difference: intervention group, 29.55±28.33 ng/ml, compared with control group, 51.97±31.16 ng/ml (p=0.007). There were no significant differences in the pre-test or post-test MW parameters between the two groups (p>0.05). Conclusions: There was a significant reduction in caspase-3 levels in AMI patients following dapagliflozin administration compared to placebo. However, there was no significant improvement in the MW parameters.
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Yudhistira et al. (2026) conducted an RCT in Acute Myocardial Infarction (n=40). Dapagliflozin vs. Placebo was evaluated on Change in serum caspase-3 levels from baseline to day 14 (p=0.007). Dapagliflozin significantly reduced post-treatment serum caspase-3 levels compared to placebo (29.55 vs 51.97 ng/ml) at 14 days in patients with acute myocardial infarction.
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