Empagliflozin benefits in patients with heart failure and preserved ejection fraction

Authors	ANKER Stefan D BUTLER Javed USMAN Muhammad Shariq FILIPPATOS Gerasimos FERREIRA Joao Pedro BOCCHI Edimar BÖHM Michael ROCCA Hans Pieter Brunner-La DONG-JU Choi CHOPRA Vijay CHUQUIURE Eduardo GIANNETTI Nadia GOMEZ-MESA Juan Esteban JANSSENS Stefan JANUZZI James L GONZÁLEZ-JUANATEY José R MERKELY Bela NICHOLLS Stephen J PERRONE Sergio V PINA Ileana L PONIKOWSKI Piotr SENNI Michele SIM David ŠPINAR Jindřich SQUIRE Iain TADDEI Stefano TSUTSUI Hiroyuki VERMA Subodh VINEREANU Dragos ZHANG Jian IWATA Tomoko SCHNEE Janet M BRUECKMANN Martina POCOCK Stuart J ZANNAD Faiez
Year of publication	2022
Type	Article in Periodical
Magazine / Source	NATURE MEDICINE
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.nature.com/articles/s41591-022-02041-5
Doi	http://dx.doi.org/10.1038/s41591-022-02041-5
Keywords	empagliflozin in heart failure; versus mid-range ejection fraction
Description	The EMPEROR-Preserved trial showed that the sodium–glucose co-transporter 2 inhibitor empagliflozin significantly reduces the risk of cardiovascular death or hospitalization for heart failure (HHF) in heart failure patients with left ventricular ejection fraction (LVEF) ?>?40%. Here, we report the results of a pre-specified analysis that separately evaluates these patients stratified by LVEF: preserved (??50%) (n?=?4,005; 66.9%) or mid-range (41–49%). In patients with LVEF ???50%, empagliflozin reduced the risk of cardiovascular death or HHF (the primary endpoint) by 17% versus placebo (hazard ratio (HR) 0.83; 95% confidence interval (CI): 0.71–0.98, P?=?0.024). For the key secondary endpoint, the HR for total HHF was 0.83 (95%CI: 0.66–1.04, P?=?0.11). For patients with an LVEF of 41–49%, the HR for empagliflozin versus placebo was 0.71 (95%CI: 0.57–0.88, P?=?0.002) for the primary outcome (Pinteraction?=?0.27), and 0.57 (95%CI: 0.42–0.79, P?<?0.001) for total HHF (Pinteraction?=?0.06). These results, together with those from the EMPEROR-Reduced trial in patients with LVEF?<?40%, support the use of empagliflozin across the full spectrum of LVEF in heart failure.