Effect of Dapagliflozin Administration on the Apoptosis Levels and Myocardial Work of Patients with Acute Myocardial Infarction (DAPOPTOSIS-MI) – A Randomized Controlled Trial

  • Yoga Yudhistira Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
  • Ahmad Yasa Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia https://orcid.org/0000-0002-2298-4851
  • Risalina Myrtha Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia https://orcid.org/0000-0001-7817-2572
  • Habibie Arifianto Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia https://orcid.org/0000-0001-5145-1299
  • Alfa Alfin Nursidiq Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia https://orcid.org/0000-0002-8923-641X
  • Trisulo Wasyanto Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia https://orcid.org/0000-0001-9900-0497
  • Heru Sulastomo Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia https://orcid.org/0000-0002-3522-2944
DOI: https://doi.org/10.30701/ijc.2090
Keywords: Apoptosis, Acute Myocardial Infarction, Dapagliflozin, Myocardial Work, DAPOPTOSIS-MI

Abstract

Background: Acute myocardial infarction (AMI) is a common cardiovascular disease and a leading cause of morbidity and mortality. Cellular death during AMI involves apoptosis (80%) and necrosis (20%). Apoptosis contributes to infarct size, Left Ventricular (LV) remodeling, and heart failure post-AMI. Previous studies suggest that dapagliflozin can reduce myocardial apoptosis, marked by decreased caspase-3 levels (preclinical study) and echocardiographic parameters (preclinical and clinical studies). However, human studies evaluating the effects of dapagliflozin on caspase-3 and myocardial work (MW) in AMI patients are not yet available. This study aims to evaluate the effect of dapagliflozin administration on caspase-3 levels and MW in AMI patients.

Methods: This was a single-center experimental study with a double-blind randomized controlled trial (RCT) design conducted among 40 AMI patients at Dr. Moewardi General Hospital, Surakarta (September–November 2024). Patients were divided into two groups: dapagliflozin and placebo. Caspase-3 levels and MW parameters (Global Work Index [GWI], Global Constructive Work [GCW], Global Wasted Work [GWW], Global Work Efficiency [GWE]) were measured at admission before and on day 14 post-treatment. Statistical analysis was performed using independent t-tests or Mann-Whitney tests, with p < 0.05 considered significant.

Results: The mean pre-test caspase-3 levels were not significantly different between the intervention group, 51.05±36.53ng/ml, and the control group, 56.44±31.01ng/ml (p=0.618). However, post-test caspase-3 levels showed a significant difference: intervention group, 29.55±28.33 ng/ml, compared with control group, 51.97±31.16 ng/ml (p=0.007). There were no significant differences in the pre-test or post-test MW parameters between the two groups (p>0.05).

Conclusions: There was a significant reduction in caspase-3 levels in AMI patients following dapagliflozin administration compared to placebo. However, there was no significant improvement in the MW parameters.

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Published
2026-09-08
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How to Cite
Yudhistira, Y., Yasa, A., Myrtha, R., Arifianto, H., Nursidiq, A., Wasyanto, T., & Sulastomo, H. (2026). Effect of Dapagliflozin Administration on the Apoptosis Levels and Myocardial Work of Patients with Acute Myocardial Infarction (DAPOPTOSIS-MI) – A Randomized Controlled Trial. Indonesian Journal of Cardiology. https://doi.org/10.30701/ijc.2090
Issue
Online First
Section
Clinical Research

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