EMERALD: An assessment of feasibility of treating coronary microvascular dysfunction with SGLT2 inhibitors

Abstract

Our study aims to determine the effectiveness of a new treatment for coronary microvascular dysfunction, a common but currently under-recognised and under-treated disease where the microscopic blood vessels of the heart do not function properly. We are comparing current standard of care to standard of care PLUS empagliflozin, a novel anti-diabetic drug which has shown great promise in this field in animal models. We hope to record baseline measurements of microvascular resistance (the key marker of CMD), as well as novel and established non-invasive measurements using CT scans and machine learning, symptom burden, quality of life, and levels of inflammation and cardiovascular risk factors, as recorded on blood tests. The blood tests, surveys, CT scan, and angiogram will then be repeated at the end of the participant's involvement in the trial at six months to assess for any interval change in these factors.

"This study aims to see if using a commonly employed drug, first discovered for the treatment of diabetes, has a positive effect on improving a condition where the microscopic blood vessels of the heart are diseased or otherwise do not function normally."