How does the drug empagliflozin protect the heart in diabetes?

Mechanisms of cardiovascular disease in diabetes mellitus  

BHF Professor Sven Plein and colleagues at the University of Leeds are studying how a drug can protect people with diabetes and heart disease from developing further heart problems. People with diabetes are more likely to have a heart attack or develop heart failure, and are also more likely to die from these conditions. Reducing this risk is a challenge. Anti-diabetic drugs that lower blood sugar levels do not reduce cardiovascular risk in the short term, although lowering blood sugar for many years does help, but is complicated by the problems caused by sugar levels dropping too low. A recent clinical trial found that giving the drug empagliflozin to people with diabetes and heart disease reduced their risk of heart failure and dying from heart disease. Researchers think the drug works by preventing heart muscle scarring (fibrosis), but this is not known for certain. In this project, Professor Plein will use magnetic resonance imaging (MRI) to study in detail how diabetes affects the heart. He believes that inflammation and fibrosis underlie heart disease in diabetes and he will detect these changes using MRI. He will also study how empagliflozin protects the heart in mice and people with diabetes. Understanding the changes in the heart in diabetes is important to develop better drugs that can protect the heart. This is particularly relevant because more people are developing diabetes and because heart disease is the most common cause of death in these people.