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Abstract Aims Patients with a reduced left ventricular ejection fraction (LVEF) following an acute myocardial infarction (MI) are at risk of progressive adverse cardiac remodelling that can lead to the development of heart failure and death. The early addition of a sodium‐glucose cotransporter 2 (SGLT2) inhibitor to standard treatment may delay or prevent progressive adverse remodelling in these patients. Methods and results EMpagliflozin to PREvent worSening of left ventricular volumes and Systolic function after Myocardial Infarction (EMPRESS‐MI) is a randomized, double‐blind, placebo‐controlled, multi‐centre trial designed to assess the effect of empagliflozin on cardiac remodelling evaluated using cardiovascular magnetic resonance (CMR) in 100 patients with left ventricular systolic dysfunction following MI. Eligible patients were those ≥12 h and ≤14 days following acute MI, with an LVEF

Despite advances in the management of ischemic heart disease worldwide, mortality in women remains disproportionally high in comparison to men, particularly in women under the age of 55. The greater prevalence of ischemia with non-obstructive coronary arteries (INOCA) in women has been highlighted as a potential cause of this disparity. Moreover, current guideline recommendations for computed tomography coronary angiography (CTCA) as the first line of investigation for stable chest pain may further amplify this inequality. Traditional cardiovascular risk factors carry greater influence in women than men in the development of ischemic heart disease. Despite this, women have been consistently under-represented in large-scale clinical trials. Chest pain in women is more likely to be overlooked due to the higher likelihood of atypical presentation and normal anatomical imaging, despite persistent symptoms and decreased quality of life indicators. Accordingly, we call into question a CTCA-first approach in clinical guidelines; instead, we favor a personalized, patient first approach. Due to the misdiagnosis of ischemic heart disease in women, a large proportion are denied access to preventative therapy. This is especially true of women with INOCA, for which there is a critical lack of specific guidelines and rigorous evidence-based therapies. Ongoing clinical trials aim to identify potential management options that may benefit those with INOCA, bringing the field closer to eliminating sex-related disparities in the diagnosis, management and prognosis of ischemic heart disease.