Effect of Dapagliflozin in Myocardial Fibrosis and Ventricular Function in Patients With a ST-segment Elevation Myocardial Infarction

Inclusion Criteria: 1. Patients between 30 - 85 years of age. 2. Patients with first infarction with ST-segment elevation documented in an ambulance or a cardiac catheterization laboratory (ST-segment elevation ≥2 mm in at least two contiguous leads) less than 12 hours after onset of symptoms that last ≥ 20 min, that is treated with primary percutaneous cardiac intervention. 3. The target lesion must be a de novo lesion located in a native vessel. 4. The patient understands and accepts the clinical monitoring and cardiac magnetic resonance. 5. The patient has to be hemodynamically stable (Killip classification 1) at the time of the initial cardiac magnetic resonance. 6. A left ventricular ejection fraction ≤50% in the baseline echocardiogram. Exclusion Criteria: 1. Pregnant or lactating women. 2. Type 1 diabetes. 3. Previous treatment with SGLT2i. 4. Severe liver disease (Child-Pugh C). 5. Kidney disease defined as stage III or worse (eGFR less than 45 ml/min). 6. Systolic blood pressure less than 90 mmHg at the screening visit. 7. Malignancy (receiving active treatment) or other life-threatening diseases. 8. Any contraindication to cardiac MRI (e.g., claustrophobia, metal implants, penetrating eye injury, or exposure to metal fragments in the eye that require medical attention). 9. Previous complicated urinary tract infection in men or repeated urinary infection in women. 10. Patients treated with fibrinolytic therapy.