The goal of this clinical trial is to learn if dapagliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT2i), can reduce coronary artery inflammation in people with acute coronary syndrome (ACS) who do not have diabetes or heart failure.
Coronary inflammation will be measured using the fat attenuation index (FAI), a marker derived from coronary CT angiography (CCTA) that quantifies inflammation in the fat tissue surrounding heart arteries.
The main questions it aims to answer are:
* Does dapagliflozin lower coronary artery inflammation as measured by FAI?
* Does dapagliflozin slow the progression of coronary plaques?
Researchers will compare participants who take dapagliflozin 10 mg daily plus standard therapy to those who receive standard therapy alone for 6 months.
Participants will:
* Undergo percutaneous coronary intervention (PCI) for ACS
* Have a baseline CCTA scan at 1 month after PCI, at which point they will be randomly assigned to receive dapagliflozin or standard care alone
* Have a follow-up CCTA scan at 6 months after randomization
* Have blood tests at the time of PCI, at randomization, and at 6 months after randomization
* Receive follow-up phone calls at 3 and 6 months after randomization
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Age ≥18 years
2. Diagnosis of acute coronary syndrome (including ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, or unstable angina)
3. Undergoing percutaneous coronary intervention (PCI)
4. Presence of multivessel coronary artery disease with at least one non-culprit vessel not undergoing revascularization (for CCTA follow-up assessment)
5. Willing and able to provide written informed consent
Exclusion Criteria:
1. Prior or current diagnosis of diabetes mellitus
2. Prior or current diagnosis of chronic heart failure
3. Treatment with any SGLT2 inhibitor within 4 weeks prior to enrollment
4. Severe hepatic impairment
5. History of recurrent urogenital infections
6. Known allergy or intolerance to SGLT2 inhibitors
7. Pregnancy or breastfeeding
8. Systolic blood pressure \<90 mmHg and/or diastolic blood pressure \<60 mmHg
9. Severe chronic kidney disease (eGFR \<30 mL/min/1.73 m²)
10. Current participation in another interventional clinical trial
11. Any other condition that, in the opinion of the investigator, would make the participant unsuitable for enrollment
Primary outcome measure(s)
Changes in FAI from baseline to 6 months in patients assessed by CCTA — From randomization to 6 months post-randomization Change in FAI of major coronary arteries (left main \[LM\], right coronary artery \[RCA\], left anterior descending \[LAD\], and left circumflex \[LCX\]) from baseline to 6 months, expressed in Hounsfield Units (HU), assessed at the patient level.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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