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AMIPhase 3DAPAPROTECTORNCT05764057

DAPAgliflozine to Attenuate Cardiac RemOdeling afTEr aCuTe myOcardial Infarction

A Phase 3 study testing Dapagliflozin propanediol (FORXIGA™/FARXIGA™1) in people with AMI and STEMI, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Recent clinical trials have proven the cardiovascular benefits of new medications for patients with heart failure with reduced ejection fraction (HFrEF), especially sodium-glucose co-transporter 2 (SGLT2) inhibitors. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
AMI, STEMI, NSTEMI
What is being tested?
Dapagliflozin propanediol (FORXIGA™/FARXIGA™1)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
450 participants
Where
1 siteFrance
Study dates
12 Jun 2023to 12 Oct 2026
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years;
  • STEMI (e.g., ST elevation above the J-point of ≥0.1 millivolt in ≥two contiguous leads or left bundle branch block) or very high-risk NSTEMI (e.g., dynamic ECG changes or ongoing chest pain or acute heart failure or hemodynamic instability independent of ECG changes or life-threatening ventricular arrhythmias) with LV dysfunction (LVEF ≤45%); after completion of PCI or angiography procedure
  • eGFR ≥ 25 mL/Min per 1.73m²;
  • Systolic blood pressure (SBP) before first dosing >100 mmHg and/or Diastolic blood pressure (DBP) >70 mmHg before first dosing;
  • Ability to provide written informed consent and willing to participate in the 6-month follow-up period.
  • Affiliation to a national health care system (AME are not allowed).

Who cannot join

  • Cardiogenic shock (SBP <90 mmHg with clinical signs of low output or patients requiring inotropic agents) at randomization;
  • Referred to surgery for coronary artery bypass grafting (CABG) or treatment of acute complications (e.g. ventricular septal rupture);
  • Any other form of diabetes than diabetes type 2
  • History of diabetic ketoacidosis (DKA); Known contra-indication to SGLT-2 inhibitors (hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption);
  • >1 episode of severe hypoglycemia within the last 6 months under treatment with insulin or sulfonylurea;
  • Acute symptomatic urinary tract infection (UTI) or genital infection at the time of randomization;
Show all 15Show fewer
  • Concomitant treatment (and/or within the 4 weeks prior to the baseline visit) with any SGLT-2 inhibitor (dapagliflozin, canagliflozin, empagliflozin)
  • Echocardiographic examination of insufficient quality to permit adequate analysis of the study end-points.
  • Impossibility to evaluate cardiac remodeling using TTE (e.g., pacemaker or defibrillator …);
  • Atrial fibrillation rhythm at randomization;
  • Life expectancy <6 month;
  • Known pregnancy at time of randomization;
  • Breastfeeding women
  • Females of childbearing potential without adequate contraceptive methods (i.e. sterilization, intrauterine device, vasectomized partner; or medical history of hysterectomy)
  • Current participation in another interventional trial. Patients under guardianship or curatorship

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Etienne PUYMIRAT, Pr contact

00331.56.09.28.51

etienne.puymirat@aphp.fr

France1 site, 1 recruiting
  • Department of Cardiology AP-HP Hôpital européen Georges - Pompidou

    Paris, 75015

    Etienne PUYMIRAT, 00331.56.09.28.51, etienne.puymirat@aphp.fr

    Recruiting

Other trials in France

About this study

Recent clinical trials have proven the cardiovascular benefits of new medications for patients with heart failure with reduced ejection fraction (HFrEF), especially sodium-glucose co-transporter 2 (SGLT2) inhibitors. There are no existing randomized clinical trials evaluating the efficacy and safety of dapagliflozin (nor any other SGLT2-inhibitor) to limit cardiac remodeling in patients with acute myocardial infarction (AMI) and left ventricular (LV) dysfunction.

Preventing cardiac remodeling, an established predictor of subsequent heart failure (HF) and cardiovascular death, is likely to translate into benefit in reducing clinical events in post-MI patients.

Read the detailed description

DAPA-PROTECTOR is a prospective multicenter, randomized, double blind, phase III trial.

Patients with confirmed AMI (e.g., STEMI or very high-risk NSTEMI) with LV dysfunction (LVEF≤45%) after completion of percutaneous coronary intervention (PCI) will be assessed for eligibility. Patients will be randomized (in a 1:1 ratio) to receive dapagliflozin (10mg once day) or placebo for 6 months, on top of standard of care as recommended in current guidelines. Treatment will be prescribed as soon as possible after admission The first TTE (TTE-1) will be performed to confirm inclusion criteria (LVEF≤45%). Four visits are scheduled: at baseline and randomization (Visit D0), at discharge from the CICU (Visit 2) at Month 3 ±2 weeks (Visit 3), and at Month 6 (+ 4 weeks) (Visit 4). After randomization, Visit 2 and Visit 3 will be scheduled to check the tolerance of the drug. In addition, a phone call will be done to the patient to make sure he's not taking any Dapagliflozin (or equivalent as Empagliflozin) in addition to experimental treatment. Finally, the last visit (Visit 4) will be scheduled to collect clinical follow-up and to perform a TTE (TTE-2). Efficacy criteria will be assessed from randomization to Month 6 by TTE. All TTE results will be anonymized and centralized at a Corelab with assessment by independent cardiologists unaware of the patient treatment group.

Being tested
Dapagliflozin propanediol (FORXIGA™/FARXIGA™1), Placebo comparator
Keywords
Acute myocardial infarction, Left ventricular dysfunction, Dapagliflozin, Transthoracic echocardiography, Cardiac remodeling, Cardiovascular Intensive Care Unit (CICU)
Medical subject headings
ST Elevation Myocardial Infarction, Non-ST Elevated Myocardial Infarction, Ventricular Dysfunction, Left

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dapagliflozin propanediol (FORXIGA™/FARXIGA™1)Drug

    Dapagliflozin (10 mg per day; per os) on top of standard of care as recommended in current guidelines* for 6 months (experimental group)

    *All patients will receive optimal medical therapy (including antithrombotic, beta-blockers, statins, angiotensin converting enzyme inhibitors or angiotensin receptor blocker or sacubitril/valsartan, diuretics, antagonists of the mineralocorticoid receptor) according to their clinical condition as recommended.

  • Placebo comparatorDrug

    Placebo daily on top of standard of care as recommended in current guidelines* for 6 months (control group)

    *All patients will receive optimal medical therapy (including antithrombotic, beta-blockers, statins, angiotensin converting enzyme inhibitors or angiotensin receptor blocker or sacubitril/valsartan, diuretics, antagonists of the mineralocorticoid receptor) according to their clinical condition as recommended.

Study groups in NCT05764057
Study groupRoleWhat they receive
Dapagliflozin 10mg daily + standard of careExperimentalDapagliflozin 10mg per day will be administered orally, as in clinical practice
Receives: Drug: Dapagliflozin propanediol (FORXIGA™/FARXIGA™1)
Placebo + standard of carePlacebo comparatorPlacebo will be administered orally
Receives: Drug: Placebo comparator

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in left ventricular ejection fraction (LVEF) from baseline to Month 6 (±1 month) by TTE

    Two primary endpoints will allow to evaluate two independent and potent predictors of mortality after AMI: 1) Cardiac systolic function, assessed by change in left ventricular ejection fraction (LVEF) from baseline to Month 6 (+4 weeks) ) by TTE; 2) Remodeling, assessed by change in left atrium volume (LAV) from baseline to Month 6 (+4 weeks) by TTE.

    Measured: 6 months (+4 weeks) from randomization

  2. Change in left atrium volume (LAV) from baseline to Month 6 (±1 month) by TTE

    Two primary endpoints will allow to evaluate two independent and potent predictors of mortality after AMI: 1) Cardiac systolic function, assessed by change in left ventricular ejection fraction (LVEF) from baseline to Month 6 (+4 weeks) ) by TTE; 2) Remodeling, assessed by change in left atrium volume (LAV) from baseline to Month 6 (+4 weeks) by TTE.

    Measured: 6 months (+4 weeks) from randomization

Secondary outcomes (12)
  1. Change in left ventricular end-systolic volume (LVESV)

    Comparison in each group from baseline to Month 6 (±1 month) using TTE. To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction.

    Measured: 6 months (+4 weeks) from randomization

  2. Change in left ventricular end-diastolic volume (LVEDV)

    Comparison in each group from baseline to Month 6 (+4 weeks) using TTE. To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction.

    Measured: 6 months (+4 weeks) from randomization

  3. Change in LV global longitudinal strain (LS)

    Comparison in each group from baseline to Month 6 (+4 weeks) using TTE. To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction.

    Measured: 6 months (+4 weeks) from randomization

  4. Change in left atrial strain (LAS)

    Comparison in each group from baseline to Month 6 (+4 weeks) using TTE. To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction.

    Measured: 6 months (+4 weeks) from randomization

  5. Duration of hospital stay (index hospitalization)

    Comparison between both groups (experimental vs. placebo) To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction.

    Measured: 6 months (+4 weeks) from randomization

  6. All-cause mortality at 6-months

    Comparison between both groups (experimental vs. placebo) Comparison between both groups (experimental vs. placebo) To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction

    Measured: 6 months (+4 weeks) from randomization

  7. Cardiovascular death or worsening HF at 6-months

    Comparison between both groups (experimental vs. placebo) To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction

    Measured: 6 months (+4 weeks) from randomization

  8. Number of re-admission due to HF at 6-months

    Comparison between both groups (experimental vs. placebo) To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction

    Measured: 6 months (±1 month) from randomization

  9. Change from baseline to Month 6 (+4 weeks) in LVESV, LVEDV, LAV, LVEF, LV global LS, LAS and pulmonary congestion (normal lung, mild, moderate or severe ultrasound lung comets [ULCs]) using TTE at month 6

    Comparison between both groups (experimental vs. placebo) To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction

    Measured: 6 months (+4 weeks) from randomization

  10. Change from baseline to Month 6 (+4 weeks) in plasma levels of NT-pro BNP and HBA1C

    Comparison between both groups (experimental vs. placebo) To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction

    Measured: 6 months (+4 weeks) from randomization

  11. Change in body weight from baseline to Month 6 (+4 weeks)

    Comparison between both groups (experimental vs. placebo) To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction

    Measured: 6 months (+4 weeks) from randomization

  12. Adverse events

    Comparison between both groups (experimental vs. placebo) of Adverse events with particular focus to those potentially related to dapagliflozin complications (e.g., all symptoms of volume depletion, major hypoglycemia, genital infections, diabetes ketoacidosis, changes in liver function parameters [ASAT, ALAT ≥3 USN].

    To assess the efficacy and safety of dapagliflozin compared to placebo in addition to optimal secondary prevention in the prevention of cardiac dysfunction after AMI with LV dysfunction.

    Measured: 6 months (+4 weeks) from randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Mar 2023
  2. Study start12 Jun 2023
  3. Primary completion12 Oct 2026 (estimated)
  4. Study completion12 Oct 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
450 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05764057
Sponsor's protocol ID
APHP211054
Other IDs
2022-001901-28, AOM20806
Acronym
DAPAPROTECTOR
Status last verified
Dec 2025
First submitted
1 Mar 2023
Last updated
19 Dec 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Dapagliflozin propanediol (FORXIGA™/FARXIGA™1) in people with AMI and STEMI, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 19 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Etienne PUYMIRAT, Pr (00331.56.09.28.51, etienne.puymirat@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in left ventricular ejection fraction (LVEF) from baseline to Month 6 (±1 month) by TTE (time frame: 6 months (+4 weeks) from randomization). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Dec 2025.

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