Study of Empagliflozin to Protect Heart Function in Adults After Embolic Stroke of Unknown Cause

What this Trial Is About

Atrial fibrillation AF is a common heart rhythm problem that greatly increases stroke risk. This research focuses on patients who have had an embolic stroke of undetermined source, many of whom later develop AF detected by implantable loop recorders. The study aims to see if empagliflozin, a Sodium Glucose Cotransporter 2 SGLT2 inhibitor, can prevent changes in the left atrium of the heart that might lead to AF, using advanced imaging and continuous heart rhythm monitoring. Participants undergoing loop recorder insertion to detect AF after a stroke will be randomly assigned to either receive empagliflozin 10 mg daily alongside usual stroke care or to continue with usual care alone for six months. Baseline and six-month follow-up assessments will include echocardiograms, electrocardiograms, and measurements of body metrics. A subset of patients will also have advanced MRI scans to explore how empagliflozin might affect the hearts function. Throughout the trial, participants will be remotely monitored via their loop recorders to detect AF episodes. Researchers will measure changes in left atrial function, AF burden, time to first AF episode, and P-wave markers at six months. The study will also track any changes in left atrial volume and body measurements, with the goal of understanding if empagliflozin influences heart rhythm and structure in this high-risk group.

EMPA-ESUS. a Randomised Control Trial to Investigate the Impact of Empagliflozin on Left Atrial Function in Patients with Embolic Stroke of Undetermined Source