The effect of empagliflozin on inflammation and oxidative stress in patients undergoing percutaneous coronary intervention, a randomized controlled trial

Empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, has demonstrated cardioprotective effects beyond glycemic control. Empagliflozin has anti-inflammatory and antioxidant effects in long-term administration; however, current evidence on its short-term impact on inflammation and oxidative stress is limited. The purpose of this study was to investigate the rapid anti-inflammatory and oxidative effects of short-term Empagliflozin therapy in patients undergoing percutaneous coronary intervention (PCI). In this double-blind, placebo-controlled, randomized clinical trial, patients with cardiovascular disease (CVD) undergoing PCI received 10 mg Empagliflozin or placebo for three days. Biomarkers of inflammation and oxidative stress, including cystatin C, pro-oxidant-antioxidant balance (PAB), and high-sensitive C-reactive protein (hs-CRP), were measured at baseline and after treatment. The Jamovi 2.7.6 software was used for statistical analysis. A total of 121 patients, including 64 males (52.8%), were enrolled. There was no significant difference in baseline characteristics between the groups. Empagliflozin significantly reduced cystatin C and PAB levels after three days of administration compared with baseline (p < 0.001, p < 0.001, respectively). Although Empagliflozin decreased hs-CRP levels, the reduction did not reach statistical significance (p = 0.14). Nevertheless, the between-group difference in hs-CRP changes became significant after adjustment (p = 0.029). Short-term treatment with Empagliflozin significantly reduced inflammation and oxidative stress in patients undergoing PCI. Our findings indicated a rapid cardioprotective mechanism during CVD events. Although the findings revealed early anti-inflammatory and antioxidative benefits, larger and longer-term studies are warranted to confirm these effects and evaluate their impact on post-PCI outcomes and long-term cardiovascular prognosis.