Impact of DApagliflozin on Cardiac Function Following Anterior Myocardial Infarction in Non-Diabetic Patients

Inclusion Criteria:

• Patients admitted with ECG Criteria for Anterior ST-elevation myocardial infarctionaccording to the fourth universal definition of myocardial infarction*, ** & showechocardiographic evidence of reduced LV ejection fraction <50% & have undergonesuccessful reperfusion by primary percutaneous coronary angiography (pPCI).

• New ST segment elevation in contagious precordial leads consistent anatomicallywith the anterior wall of myocardium:

• Men ≥ 40 years: 2 mV in leads V2-V3 &/or 1 mV in other precordial leads

• Men <40 years: 2.5 mV in leads V2-V3 &/or 1 mV in other precordial leads

• Women (regardless of age): 1.5 mV in leads V2-V3 &/or 1 mV in otherprecordial leads ** Patients with admission ECG showing DeWinter'sSyndrome, Wellen Syndrome, New onset left bundle branch block, new onsetright bundle branch block will also be included.

Exclusion Criteria:

1. Patients with Diabetes Miletus (Type 1 (DMT2), Type 1 (DMT1), secondary diabetes (e.g., endocrinopathies)

2. Patients already diagnosed with heart failure prior to this event

3. Patients on cardiotoxic chemotherapeutic medications.

4. Patients with haemoglobinopathies.

5. Patients with chronic organ damage (i.e., chronic hepatitis with MELD score >10,Stage 4 & 5 renal disease).

6. Patients already on SGLT2i.

7. Patients who will require additional anticoagulant therapy (i.e.: patients withtransthoracic echocardiographic evidence of left ventricular thrombus).

8. Patients with contraindications for use of dapagliflozin including patients withseverely impaired renal function (eGFR <30ml/min/1.73m2) &/OR previous history ofgenitourinary infections (i.e.: urosepsis, pyelonephritis & fournier's gangrene) &/OR at high risk of such infections.