DACAMIImpact of DApagliflozin on Cardiac Function Following Anterior Myocardial Infarction in Non-Diabetic Patients - DACAMI (a Randomized Controlled Clinical Trial)

Date de début de l'étude : 1 octobre 2021

Inclusion Criteria: * Patients admitted with ECG Criteria for Anterior ST-elevation myocardial infarction according to the fourth universal definition of myocardial infarction\*, \*\* \& show echocardiographic evidence of reduced LV ejection fraction \<50% \& have undergone successful reperfusion by primary percutaneous coronary angiography (pPCI). * New ST segment elevation in contagious precordial leads consistent anatomically with the anterior wall of myocardium: * Men ≥ 40 years: 2 mV in leads V2-V3 \&/or 1 mV in other precordial leads * Men \<40 years: 2.5 mV in leads V2-V3 \&/or 1 mV in other precordial leads * Women (regardless of age): 1.5 mV in leads V2-V3 \&/or 1 mV in other precordial leads \*\* Patients with admission ECG showing DeWinter's Syndrome, Wellen Syndrome, New onset left bundle branch block, new onset right bundle branch block will also be included. Exclusion Criteria: 1. Patients with Diabetes Miletus (Type 1 (DMT2), Type 1 (DMT1), secondary diabetes (e.g., endocrinopathies) 2. Patients already diagnosed with heart failure prior to this event 3. Patients on cardiotoxic chemotherapeutic medications. 4. Patients with haemoglobinopathies. 5. Patients with chronic organ damage (i.e., chronic hepatitis with MELD score \>10, Stage 4 \& 5 renal disease). 6. Patients already on SGLT2i. 7. Patients who will require additional anticoagulant therapy (i.e.: patients with transthoracic echocardiographic evidence of left ventricular thrombus). 8. Patients with contraindications for use of dapagliflozin including patients with severely impaired renal function (eGFR \<30ml/min/1.73m2) \&/OR previous history of genitourinary infections (i.e.: urosepsis, pyelonephritis \& fournier's gangrene) \&/OR at high risk of such infections.