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The cardioprotective effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) may involve vasopressin modulation through fluid redistribution, but whether this effect persists long-term in high-cardiovascular-risk patients with newly detected dysglycaemia remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this post-hoc analysis of the SOCOGAMI double-blind, placebo-controlled trial, 42 patients (mean age 67.5\u00a0years, 19% females) with impaired glucose tolerance or newly detected type 2 diabetes following an ACS and no heart failure were randomized to empagliflozin 25\u00a0mg\/day (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920) or placebo (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922) for 7\u00a0months. Copeptin was measured during oral glucose tolerance tests (OGTT) at baseline, after 7\u00a0months on-treatment, and 3\u00a0months after treatment withdrawal. Treatment effects were assessed by repeated-measures ANOVA with treatment\u2009\u00d7\u2009time interaction and linear mixed-effects models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Haematocrit, but not copeptin, showed a significant between-group difference at 7\u00a0months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.63, respectively). Both markers returned toward baseline after treatment withdrawal, but the overall treatment\u2009\u00d7\u2009time interaction was not significant for either (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.72 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.64 respectively). Results were unchanged after accounting for a baseline imbalance in diuretic use (35% vs. 14%). Copeptin was not associated with the glucose-lowering effect of empagliflozin and no differential copeptin response during the OGTT across groups or visits was observed. In exploratory analyses, copeptin correlated with arterial pulse wave velocity at baseline (rs\u2009=\u20090.40, unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this post-hoc analysis, empagliflozin treatment was not associated with statistically significant sustained vasopressin secretion in post-ACS patients with newly detected dysglycaemia and preserved cardiac function. Due to the limited power and the absence of early on-treatment sampling these findings cannot exclude AVP modulation and warrant confirmation in adequately powered studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>EudraCT number 2015-004571-73.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12933-026-03312-y","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:25:25Z","timestamp":1785216325000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of empagliflozin on copeptin levels in patients with recent acute coronary syndrome and newly detected dysglycaemia: a post-hoc analysis of the SOCOGAMI randomized controlled trial"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7627-3169","authenticated-orcid":false,"given":"Elena","family":"Fortin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olle","family":"Melander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Ferrannini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"N\u00e4sman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Norhammar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Ryd\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stina","family":"Smetana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Svensson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Mellbin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"issue":"1","key":"3312_CR1","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1177\/1479164114551746","volume":"12","author":"V Ritsinger","year":"2015","unstructured":"Ritsinger V, Tanoglidi E, Malmberg K, N\u00e4sman P, Ryd\u00e9n L, Tenerz \u00c5, et al. 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The study was conducted in compliance with principles in the Declaration of Helsinki, 1996 version, as well as in accordance with the ICH Harmonized Tripartite Guideline for Good Clinical Practice and applicable regulatory requirements. The protocol was approved by the Regional Ethics committee in Stockholm (Dnr 2015:4\/11) and the trial is registered in the European Union Drug Regulating Authorities Clinical Trials Database (EudraCT) with the number 2015-004571-73. The funder had no role in design and conduct of the trial.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"212"}}