The purpose of the research is to determine whether a class of medication called SGLT2 inhibitor will improve the heart's function and reduce its enlargement after a heart attack. Participation in this study will involve taking this class of medication (or a placebo) once daily for six months, one cardiac magnetic resonance imaging (MRI) test during your initial hospitalization, follow-up phone calls at 1 and 3 months, and one cardiac MRI and clinic visit at six months. This is a single center study.
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Inclusion Criteria: * Patients with their first STEMI (\>18 years) who underwent successful primary PCI and able to give informed consent * At least mild LV dysfunction (LVEF \< 50%) on echocardiogram, cMRI or Left Ventriculargram following PCI * Infarct size that is \> 10% of LV mass * The presence of MVO that is \> 10% of infarct size Exclusion Criteria: * Contraindication to cardiac MRI * Life expectancy \< 1 year * Previous CABG or Valve Surgery * Previous STEMI * Pregnant or planning to become pregnant or lactating women * Cardiogenic shock (not resolved) * Atrial fibrillation or recurrent sustained ventricular arrhythmias (excluding PVCs) * GFR\<30 ml/min/1.73m2 or end-stage renal disease on dialysis * Type 1 diabetes mellitus or history of diabetic ketoacidosis * Type I or II diabetes with insulin use * Prior intolerance of SGLT2 inhibitors * Current use of SGLT2 inhibitors (randomized patients only) * Contraindications to gadolinium