Abstract 4141695: Empagliflozin reduces both infarct size and no-reflow in a rat experimental myocardial ischemia/reperfusion model

Background: Whether acute administration of empagliflozin (EMPA) , a sodium glucose cotransporter-2 could reduce myocardial infarct size is controversial. Its effect on no-reflow is unknown. We determined whether intravenous administration of EMPA at 10 min before coronary occlusion combined with 1 min prior to reperfusion, could limit myocardial infarct (MI) size and the no-reflow phenomenon compared to chronic therapy in a standardized rat model. Methods: Male SD rats were randomized into 3 groups (n = 13 in each group): (1) Control group: rats were fed diet without EMPA; (2) Acute treatment group: EMPA was given intravenously through the jugular vein at 10 minutes prior to coronary artery occlusion (10 mg/kg) and repeated at one minute prior to reperfusion; (3) Chronic treatment group: EMPA was administrated to the rats by food (20 mg/kg) for 7 days before myocardial ischemia. The coronary artery occlusion was maintained for 30 minutes followed by 3 hours of reperfusion. Results: The ischemic risk area (blue dye technique) was comparable among the 3 groups. MI size (Triphenyl tetrazolium staining) as percent of risk zone was significantly reduced in both acute EMPA treated group (46.9 ± 2.0%) and chronic EMPA group (48.8 ± 5.8%) compared to the control group (70.0 ± 2.6%; p = 0.005, figure A). No-reflow size (thioflavin S technique) as percent of risk zone was significantly smaller in the acute EMPA treated group (36.3 ± 3.3%) and chronic EMPA group (33.9 ± 4.3%) compared to the control group (53.4 ± 3.3%; p = 0.012, figure B). Conclusions: Both acute and chronic EMPA treatment significantly reduced infarct size. We showed for the first time that EMPA reduced no-reflow in an acute rat myocardial ischemia/reperfusion model.