Evidence mapPaperPMID 41569218Full record

ArticleJACC. Asia2026

Sex Differences in Antiarrhythmic Effects of Empagliflozin: The EMPA-ICD Trial Subanalysis.

Miyo Nakano, Yusuke Kondo, Shinya Fujiki, Yuki Shiko, Yohei Kawasaki, Yoshihisa Nakagawa, Kazuyoshi Takahashi, Masaaki Okabe, Kengo Kusano, Shingen Owada and 8 more

Abstract read
In one paragraph

Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Miyo NakanoDepartment of Advanced Cardiorhythm Therapeutics, Chiba University Graduate School of Medicine, Chiba, Japan.
Yusuke KondoDepartment of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. Electronic address: yuusukondou-circ@umin.ac.jp.
Shinya FujikiDepartment of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Yuki ShikoDepartment of Biostatistics, Graduate School of Medicine, Saitama Medical University, Saitama, Japan.
Yohei KawasakiDepartment of Biostatistics, Graduate School of Medicine, Saitama Medical University, Saitama, Japan.
Yoshihisa NakagawaDepartment of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan.
Kazuyoshi TakahashiDepartment of Cardiology, Niigata City General Hospital, Niigata, Japan.
Masaaki OkabeDepartment of Cardiology, Tachikawa General Hospital, Niigata, Japan.
Kengo KusanoDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Shingen OwadaDepartment of Cardiology, Iwate Medical University Hospital, Iwate, Japan.
Kenichi TsujitaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Yoshiaki KubotaDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
Hirofumi TomitaDepartment of Cardiology and Nephrology, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Toshihisa AnzaiDepartment of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Kenichi IijimaDepartment of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Takahiro TanakaClinical and Translational Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan.
Yoshio KobayashiDepartment of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Tohru MinaminoDepartment of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe EMPA-ICD (Empagliflozin in Patients with Type 2 Diabetes Treated with an Implantable Cardioverter-Defibrillator; jRCTs031180120) trial is a prospective, multicenter, randomized, double-blind, placebo-controlled study evaluating the effects of empagliflozin on ventricular arrhythmias (VAs) in patients with type 2 diabetes (T2DM) treated with implantable cardioverter-defibrillators (ICDs). The trial showed that empagliflozin reduces VAs, but whether this effect differs by sex remains unclear.

objectivesThis EMPA-ICD trial subanalysis aimed to assess sex-specific differences in the antiarrhythmic effects of empagliflozin in ICD-treated patients with T2DM.

methodsThe primary endpoint was the change in the number of VAs, including nonsustained ventricular tachycardia, sustained ventricular tachycardia, and ventricular fibrillation, detected by the ICDs over 24 weeks.

resultsBetween April 2019 and April 2021, a total of 150 patients were randomized to receive either empagliflozin or placebo at 31 centers in Japan. In men, the rate of ventricular arrhythmia events was significantly lower in the empagliflozin group than in the placebo group, with a rate ratio of 0.33 (95% CI: 0.27-0.39; P < 0.001). In women, the rate ratio was 1.78 (95% CI: 0.54-5.90; P = 0.35), with no statistically significant difference observed. Notably, a significant interaction between sex and treatment was observed, suggesting a sex-specific treatment response (P = 0.006)

conclusionsThe arrhythmic effect of empagliflozin in patients with T2DM treated with ICDs appears to be more pronounced in men than in women. These findings underscore the need for investigating sex-specific responses to sodium-glucose cotransporter 2 inhibitors, advancing personalized strategies for arrhythmia management.

Indexed as

empagliflozinICDsextype 2 diabetesventricular arrhythmia

Identifiers

PMID41569218
PMCPMC13153910

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.