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    Clinical Trial Results:
    Impact of EMpagliflozin on cardiac function and biomarkers of heart failure in patients with acute MYocardial infarction (EMMY-Trial) – a phase III Study

    Summary
    EudraCT number
    2016-004591-22
    Trial protocol
    AT  
    Global end of trial date
    03 May 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    08 Sep 2023
    First version publication date
    08 Sep 2023
    Other versions
    Summary report(s)
    Final Report EMMY Trial

    Trial information

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    Trial identification
    Sponsor protocol code
    HS-2017-01
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03087773
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Medical University of Graz
    Sponsor organisation address
    Neue Stiftingtalstrasse 6, Graz, Austria, 8010
    Public contact
    Dr. Norbert Tripolt, Medical University of Graz, 43 316385 81310, norbert.tripolt@medunigraz.at
    Scientific contact
    Prof. Harald Sourij, MBA, Medical University of Graz, 43 316385 81310, ha.sourij@medunigraz.at
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    29 Jun 2022
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    03 May 2022
    Global end of trial reached?
    Yes
    Global end of trial date
    03 May 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to investigate the impact of Empagliflozin on biomarkers of heart failure in patients with myocardial infarction with and without type 2 diabetes mellitus within 6 months after the event.
    Protection of trial subjects
    ethical standards were followed, the trial adhere to strict ethical standards to ensure that participants were treated fairly and with respect protecting the privacy and confidentiality of participants education and training in protection of clinical trials participants for all study team members
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    03 Apr 2017
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Scientific research
    Long term follow-up duration
    24 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Austria: 476
    Worldwide total number of subjects
    476
    EEA total number of subjects
    476
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    361
    From 65 to 84 years
    115
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Study sites recruited competively and the clinic staff of the intensive care unit informed patients about the possibility of being enrolled in this study. No study-related procedures were undertaken before obtaining informed consent.

    Pre-assignment
    Screening details
    After obtaining ICF at the screening visit, subject´s eligibility was further assessed and documented by using a SDF with a list of inclusion/exclusion criteria, medical history were acquired and the following measurements were performed: body weight, height, blood parameters. Lab results up to 2 days before screening were used to test eligibility.

    Period 1
    Period 1 title
    Baseline Period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Empagliflozin
    Arm description
    Participants of this group received empagliflozin (10mg)
    Arm type
    Experimental

    Investigational medicinal product name
    Empagliflozin
    Investigational medicinal product code
    A10BK03
    Other name
    Jardiance
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    orally once daily for 6 months (10mg).

    Arm title
    Placebo
    Arm description
    Participants of this group received placebo
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    10mg oral per day

    Number of subjects in period 1
    Empagliflozin Placebo
    Started
    237
    239
    Completed
    217
    227
    Not completed
    20
    12
         Consent withdrawn by subject
    8
    4
         Lost to follow-up
    12
    8

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Baseline Period
    Reporting group description
    -

    Reporting group values
    Baseline Period Total
    Number of subjects
    476 476
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    57 (52 to 64) -
    Gender categorical
    Units: Subjects
        Female
    84 84
        Male
    392 392

    End points

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    End points reporting groups
    Reporting group title
    Empagliflozin
    Reporting group description
    Participants of this group received empagliflozin (10mg)

    Reporting group title
    Placebo
    Reporting group description
    Participants of this group received placebo

    Subject analysis set title
    Intention-to-treat
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The primary endpoint (change in NT-proBNP from baseline to week 26) was analysed in the intention-to-treat (ITT) population using a robust linear mixed effect model (LMEM) in which the dependent variable was log-transformed NT-proBNP and the fixed effects were treatment, visit, treatment-by-visit interaction, the stratification factors sex and presence/absence of type 2 diabetes, and baseline NT-proBNP concentration.

    Primary: NT-proBNP

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    End point title
    NT-proBNP
    End point description
    Median and IQR of NTproBNP percent change according to treatment and visits
    End point type
    Primary
    End point timeframe
    Baseline to Week 26
    End point values
    Empagliflozin Placebo
    Number of subjects analysed
    212
    209
    Units: pg/ml
        median (inter-quartile range (Q1-Q3))
    -84.9 (-91.7 to -72.6)
    -82.2 (-89.2 to -69.8)
    Statistical analysis title
    Linear mixed effect model
    Statistical analysis description
    The primary endpoint (change in NT-proBNP from baseline to week 26) was analysed in the intention-to-treat (ITT) population using a robust linear mixed effect model (LMEM) in which the dependent variable was log-transformed NT-proBNP and the fixed effects were treatment, visit, treatment-by-visit interaction, the stratification factors sex and presence/absence of type 2 diabetes, and baseline NT-proBNP concentration. For the primary analysis no missing data were imputed.
    Comparison groups
    Empagliflozin v Placebo
    Number of subjects included in analysis
    421
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    ≤ 0.05 [1]
    Method
    t-test, 2-sided
    Confidence interval
    Notes
    [1] - To claim superiority of empagliflozin over placebo, the primary efficacy analysis was required to demonstrate a statistically significant treatment at week 26 at a 5% alpha level with a two-sided test.

    Secondary: Left ventricular ejection fraction

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    End point title
    Left ventricular ejection fraction
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline to Week 26
    End point values
    Empagliflozin Placebo
    Number of subjects analysed
    212
    209
    Units: %
        median (inter-quartile range (Q1-Q3))
    4.7 (3.6 to 5.8)
    7.6 (5.2 to 9.9)
    No statistical analyses for this end point

    Secondary: E/é Ratio

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    End point title
    E/é Ratio
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline to Week 26
    End point values
    Empagliflozin Placebo
    Number of subjects analysed
    212
    209
    Units: ratio
        median (inter-quartile range (Q1-Q3))
    -9.7 (-13.1 to -6.4)
    -3.5 (-7.4 to -0.4)
    No statistical analyses for this end point

    Secondary: Left ventricular end-systolic volume

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    End point title
    Left ventricular end-systolic volume
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline to Week 26
    End point values
    Empagliflozin Placebo
    Number of subjects analysed
    212
    209
    Units: ml
        median (inter-quartile range (Q1-Q3))
    -2.2 (-6.4 to 2.0)
    12.1 (6.4 to 17.7)
    No statistical analyses for this end point

    Secondary: Left ventricular end-diastolic volume

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    End point title
    Left ventricular end-diastolic volume
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline to Week 26
    End point values
    Empagliflozin Placebo
    Number of subjects analysed
    212
    209
    Units: ml
        median (inter-quartile range (Q1-Q3))
    5.9 (1.8 to 10.1)
    14.8 (10.2 to 19.4)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse event date was collected over 5 years from May 2017 (first patient first visit) until May 2022 (last patient last visit)
    Adverse event reporting additional description
    Adverse events (AE) that occured during this study were recorded on AE case report forms. The Sponsor reported all SAEs and AEs which were relevant for a reported SAE as well as Adverse Events of Special Interest by fax or other secure method using Böhringer Ingelheim (BI) IIS SAE form to the BI Unique Entry Point. The sponsor reported the SAEs to
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.0
    Reporting groups
    Reporting group title
    Empagliflozin Group
    Reporting group description
    -

    Reporting group title
    Placebo Group
    Reporting group description
    -

    Serious adverse events
    Empagliflozin Group Placebo Group
    Total subjects affected by serious adverse events
         subjects affected / exposed
    36 / 237 (15.19%)
    41 / 239 (17.15%)
         number of deaths (all causes)
    3
    0
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Pulmonary carcinoma
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Benign mass
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Haematoma Retroperitoneal
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Weber B fracture
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Morphine intoxication
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Peripheral arterial occlusive disease
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Hernia
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Mitral valve disease
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    0 / 237 (0.00%)
    2 / 239 (0.84%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    6 / 237 (2.53%)
    2 / 239 (0.84%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    3 / 237 (1.27%)
    3 / 239 (1.26%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Stress Dyspnoea
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic cardiomyopathy
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Elevated troponin I
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiogenic shock
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    ICD-implantation
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute heart failure
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Coronary artery stenosis
         subjects affected / exposed
    6 / 237 (2.53%)
    2 / 239 (0.84%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 237 (0.42%)
    2 / 239 (0.84%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac decompensation
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ventricular tachycardia
         subjects affected / exposed
    1 / 237 (0.42%)
    2 / 239 (0.84%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mitral regurgitation
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    cardiac scintigraphy
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Gastroenteritis
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subileus
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal bleeding
         subjects affected / exposed
    0 / 237 (0.00%)
    2 / 239 (0.84%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epigastrial pain
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Appendicitis perforated
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Obstructive sleep apnoea syndrome
         subjects affected / exposed
    0 / 237 (0.00%)
    2 / 239 (0.84%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 237 (0.84%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Gout attack
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Empagliflozin Group Placebo Group
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    129 / 237 (54.43%)
    109 / 239 (45.61%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Benign prostatic hyperplasia
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    10
    1
    Vascular disorders
    Syncope
         subjects affected / exposed
    4 / 237 (1.69%)
    3 / 239 (1.26%)
         occurrences all number
    4
    6
    Periarterial occlusive disease
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences all number
    1
    1
    General disorders and administration site conditions
    Sleep disorder
         subjects affected / exposed
    3 / 237 (1.27%)
    0 / 239 (0.00%)
         occurrences all number
    4
    0
    Hair disorder
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Muscle fatigue
         subjects affected / exposed
    3 / 237 (1.27%)
    0 / 239 (0.00%)
         occurrences all number
    3
    0
    Fatigue
         subjects affected / exposed
    7 / 237 (2.95%)
    5 / 239 (2.09%)
         occurrences all number
    10
    7
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    11 / 237 (4.64%)
    4 / 239 (1.67%)
         occurrences all number
    19
    10
    Haemoptysis
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Cough
         subjects affected / exposed
    3 / 237 (1.27%)
    0 / 239 (0.00%)
         occurrences all number
    4
    0
    pulmonary emphysema
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Dyspnoea exertional
         subjects affected / exposed
    8 / 237 (3.38%)
    9 / 239 (3.77%)
         occurrences all number
    15
    11
    Bronchitis
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Psychiatric disorders
    Depressed mood
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    4
    0
    Injury, poisoning and procedural complications
    Haematoma
         subjects affected / exposed
    1 / 237 (0.42%)
    4 / 239 (1.67%)
         occurrences all number
    1
    5
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    2
    Tachycardia
         subjects affected / exposed
    1 / 237 (0.42%)
    2 / 239 (0.84%)
         occurrences all number
    1
    2
    elevated Troponin values
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Paroxysmal arrhythmia
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Hypertension
         subjects affected / exposed
    3 / 237 (1.27%)
    1 / 239 (0.42%)
         occurrences all number
    3
    4
    Hypotension
         subjects affected / exposed
    2 / 237 (0.84%)
    1 / 239 (0.42%)
         occurrences all number
    2
    1
    Vertigo
         subjects affected / exposed
    8 / 237 (3.38%)
    9 / 239 (3.77%)
         occurrences all number
    14
    13
    Angina pectoris
         subjects affected / exposed
    7 / 237 (2.95%)
    6 / 239 (2.51%)
         occurrences all number
    7
    6
    Chest pain
         subjects affected / exposed
    13 / 237 (5.49%)
    12 / 239 (5.02%)
         occurrences all number
    13
    16
    Pressure in the chest
         subjects affected / exposed
    9 / 237 (3.80%)
    5 / 239 (2.09%)
         occurrences all number
    12
    9
    Bradycardia
         subjects affected / exposed
    0 / 237 (0.00%)
    3 / 239 (1.26%)
         occurrences all number
    0
    5
    Apex thrombus
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences all number
    3
    0
    Ventricular thrombus
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences all number
    1
    1
    Stenosis
         subjects affected / exposed
    3 / 237 (1.27%)
    1 / 239 (0.42%)
         occurrences all number
    3
    1
    Acute coronary syndrome
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Heart failure
         subjects affected / exposed
    0 / 237 (0.00%)
    2 / 239 (0.84%)
         occurrences all number
    0
    2
    Cardial decompensation
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Mitral valve incompetence
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Nervous system disorders
    Tremor
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Headache
         subjects affected / exposed
    2 / 237 (0.84%)
    2 / 239 (0.84%)
         occurrences all number
    3
    2
    Paraesthesia
         subjects affected / exposed
    0 / 237 (0.00%)
    2 / 239 (0.84%)
         occurrences all number
    0
    3
    loss of strength
         subjects affected / exposed
    2 / 237 (0.84%)
    1 / 239 (0.42%)
         occurrences all number
    2
    1
    Dysaesthesia
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences all number
    1
    1
    Radiculitis brachial
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Blood and lymphatic system disorders
    Elevated CK values
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences all number
    1
    1
    Epistaxis
         subjects affected / exposed
    2 / 237 (0.84%)
    3 / 239 (1.26%)
         occurrences all number
    5
    3
    Elevated albumin-creatinin levels
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Increas lipoprotein (a)
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Elevated Transaminasis
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Ear and labyrinth disorders
    Tinnitus
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences all number
    2
    0
    Otitis media
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Ear infection
         subjects affected / exposed
    2 / 237 (0.84%)
    3 / 239 (1.26%)
         occurrences all number
    2
    3
    Gastrointestinal disorders
    Appendicitis perforated
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Gastritis
         subjects affected / exposed
    4 / 237 (1.69%)
    0 / 239 (0.00%)
         occurrences all number
    10
    0
    Obstipation
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    2
    0
    Nausea
         subjects affected / exposed
    2 / 237 (0.84%)
    4 / 239 (1.67%)
         occurrences all number
    4
    6
    Hunger
         subjects affected / exposed
    3 / 237 (1.27%)
    0 / 239 (0.00%)
         occurrences all number
    3
    0
    Diarrhoea
         subjects affected / exposed
    4 / 237 (1.69%)
    2 / 239 (0.84%)
         occurrences all number
    5
    2
    Flatulence
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences all number
    3
    0
    Haematochezia
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences all number
    2
    0
    Abdominal pain
         subjects affected / exposed
    3 / 237 (1.27%)
    1 / 239 (0.42%)
         occurrences all number
    3
    1
    Reflux gastritis
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences all number
    2
    0
    Hepatic infection
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    2
    Vomiting
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Hepatobiliary disorders
    elevated GGT values
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    elevated Bilirubin
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Skin and subcutaneous tissue disorders
    Hyperhidrosis
         subjects affected / exposed
    5 / 237 (2.11%)
    3 / 239 (1.26%)
         occurrences all number
    6
    6
    Exanthema subitum
         subjects affected / exposed
    3 / 237 (1.27%)
    4 / 239 (1.67%)
         occurrences all number
    3
    4
    Endocrine disorders
    elevated TSH values
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    HbA1c increase
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Hypoglycaemia
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    2
    0
    Hyperthyroidism
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Mastodynia
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Thyroid nodules
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Arthritis
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Muscle pain
         subjects affected / exposed
    1 / 237 (0.42%)
    2 / 239 (0.84%)
         occurrences all number
    2
    2
    Pain in extremity
         subjects affected / exposed
    6 / 237 (2.53%)
    3 / 239 (1.26%)
         occurrences all number
    7
    3
    Oedema
         subjects affected / exposed
    2 / 237 (0.84%)
    0 / 239 (0.00%)
         occurrences all number
    2
    0
    Swelling
         subjects affected / exposed
    1 / 237 (0.42%)
    2 / 239 (0.84%)
         occurrences all number
    1
    2
    Fracture
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Rhabdomyolysis
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    joint inflammation
         subjects affected / exposed
    1 / 237 (0.42%)
    2 / 239 (0.84%)
         occurrences all number
    1
    2
    Thoracic pain
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    11 / 237 (4.64%)
    7 / 239 (2.93%)
         occurrences all number
    18
    8
    Genital fungal infection
         subjects affected / exposed
    7 / 237 (2.95%)
    2 / 239 (0.84%)
         occurrences all number
    7
    2
    COVID-19
         subjects affected / exposed
    1 / 237 (0.42%)
    2 / 239 (0.84%)
         occurrences all number
    1
    3
    Cold burn
         subjects affected / exposed
    2 / 237 (0.84%)
    2 / 239 (0.84%)
         occurrences all number
    2
    5
    Epididymitis
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Influenza
         subjects affected / exposed
    3 / 237 (1.27%)
    1 / 239 (0.42%)
         occurrences all number
    3
    1
    Tooth infection
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences all number
    1
    1
    Herpes zoster
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Pharyngitis lateralis
         subjects affected / exposed
    0 / 237 (0.00%)
    1 / 239 (0.42%)
         occurrences all number
    0
    1
    athletes food
         subjects affected / exposed
    1 / 237 (0.42%)
    0 / 239 (0.00%)
         occurrences all number
    1
    0
    Metabolism and nutrition disorders
    Gout
         subjects affected / exposed
    0 / 237 (0.00%)
    3 / 239 (1.26%)
         occurrences all number
    0
    6
    Gout arthritis
         subjects affected / exposed
    1 / 237 (0.42%)
    1 / 239 (0.42%)
         occurrences all number
    1
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    02 Oct 2017
    New study site Klinikum Klagenfurt am Wörthersee
    21 Nov 2017
    Announcement of a cardiac ultrasound sub-study
    29 Nov 2017
    New study site Klinikum Rudolfstiftung
    08 Mar 2018
    Change of the upper limit of age from 75 to 80 years in the inclusion criteria & new study site Kardinal Schwarzenberg Klinikum Schwarzach
    22 Aug 2018
    New study sites LKH Graz West and University Hospital Linz
    14 Nov 2018
    New study sites BHB Eisenstadt and University Hospital St. Pölten
    04 Feb 2020
    Change of Principal Investigator at study site Klinikum Klagenfurt
    02 Oct 2020
    Additional sub-study in participants at study site University Hospital Graz for microbiome analysis

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/36036746
    For support, Contact us.
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