急性心肌梗死（AMI）对心血管疾病（CVD）构成重大威胁，导致心力衰竭（HF）和心血管死亡的高风险。越来越多的证据显示，无论是否患有糖尿病，钠葡萄糖协同转运体-2（SGLT2）抑制剂都有潜在改善心血管结局的可能性，但AMI患者的证据有限。此外，对于其效果是否可以归因于改善左室（LV）功能存在争议，这进一步复杂化了对其潜在机制的理解。本研究是在中国一家大型三级教学医院进行的前瞻性、IV期、开放标签、平行分组、单中心试验。共纳入120例同时患有AMI和2型糖尿病（T2DM）的患者。接受SGLT2抑制剂治疗的被视为实验组，接受其他抗糖尿病药物治疗的被视为对照组。主要结局指标是基线期至1年随访期间通过心脏磁共振（CMR）成像测量的LV舒张末期容积指数（LVESVi）的变化。次要结局包括其他LV参数，如LV质量、LV容积和LV射血分数（EF）；生活质量和功能能力，如Kansas City心肌病问卷总结分数（KCCQ-OS）和EuroQol-5维度（EQ-5D）；与AMI诊断参数和心血管保护可能机制相关的生物标志物，如肌酸激酶、肌钙蛋白T（TnT）水平、肌钙蛋白I（TnI）水平、可溶性抑制性肿瘤-2（sST2）、半乳糖凝集素-3（Gal-3）、纤维生长因子21（FGF21）和微小RNA（miRNA）水平。本研究旨在调查在实际世界环境中，通过测量CMR、生活质量和功能能力，SGLT2抑制剂是否能改善AMI患者的LV功能，提供有关SGLT2抑制剂对心脏保护的潜在机制的证据。https://www.chictr.org.cn/showproj.html?proj=173672，登记号ChiCTR2200065792。版权所有 © 2023 Cao, Shi, Yu, Ma, Zhang, Xu, Jiang, Ge, Shen and Pu.

Acute myocardial infarction (AMI) poses a significant threat to cardiovascular diseases (CVDs), leading to a high risk of heart failure (HF) and cardiovascular death. Growing evidence has unveiled the potential of sodium-glucose cotransporter-2 (SGLT2) inhibitors to improve cardiovascular outcomes in patients with CVD regardless of diabetes, but there is limited evidence in AMI patients. Furthermore, it is controversial whether the effects can be ascribed to the amelioration of left ventricular (LV) function, which further complicates the understanding of their underlying mechanism.This study is a prospective, phase IV, open-label, parallel group, single-center trial conducted in a large tertiary teaching hospital in China. A total of 120 patients with AMI and type 2 diabetes mellitus (T2DM) will be included. Those who received SGLT2 inhibitors are considered as the experimental group, and those taking other antidiabetic agents are considered as the control group. The primary outcome is change in LV end-systolic volume index (LVESVi) measured by cardiac magnetic resonance (CMR) imaging from baseline during 1-year follow-up period. Secondary outcomes include other LV parameters such as LV mass, LV volume, and LV ejection fraction (EF); quality of life and functional capacity such as Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS) and EuroQol-5 dimension (EQ-5D); biomarkers associated with diagnostic parameters of AMI and possible mechanisms on cardiovascular protection, such as creatine kinase, troponin T (TnT) level, troponin I (TnI) level, soluble suppression of tumorigenicity-2 (sST2), galectin-3 (Gal-3), fibroblast growth factor 21 (FGF21), and microRNA (miRNA) level.This study aims to investigate whether SGLT2 inhibitors could improve LV function by measuring CMR, quality of life, and functional capacity in patients with AMI in real-world settings, providing evidence on the underlying mechanism of SGLT2 inhibitors on cardioprotection.https://www.chictr.org.cn/showproj.html?proj=173672, identifier ChiCTR2200065792.Copyright © 2023 Cao, Shi, Yu, Ma, Zhang, Xu, Jiang, Ge, Shen and Pu.