Empagliflozin in Heart Failure with a Preserved Ejection Fraction

The EMPEROR-Preserved trial investigated empagliflozin's effects in 5988 patients with heart failure and preserved ejection fraction (HFpEF). Participants were randomized to empagliflozin (10 mg/day) or placebo, added to standard therapy. Over a median 26.2-month follow-up, empagliflozin reduced the primary composite outcome (cardiovascular death or heart failure hospitalization) by 21% (HR 0.79; 95% CI, 0.69–0.90; P<0.001), driven by a 29% lower risk of heart failure hospitalization. Benefits were consistent across subgroups, including patients with/without diabetes. Empagliflozin also slowed eGFR decline (-1.25 vs. -2.62 mL/min/1.73 m²/year; P<0.001). Safety profiles were similar, though genital/urinary infections and hypotension were more frequent with empagliflozin.

The EMPEROR-Preserved trial investigated empagliflozin's effects in 5988 patients with heart failure and preserved ejection fraction (HFpEF). Participants were randomized to empagliflozin (10 mg/day) or placebo, added to standard therapy. Over a median 26.2-month follow-up, empagliflozin reduced the primary composite outcome (cardiovascular death or heart failure hospitalization) by 21% (HR 0.79; 95% CI, 0.69–0.90; P<0.001), driven by a 29% lower risk of heart failure hospitalization. Benefits were consistent across subgroups, including patients with/without diabetes. Empagliflozin also slowed eGFR decline (-1.25 vs. -2.62 mL/min/1.73 m²/year; P<0.001). Safety profiles were similar, though genital/urinary infections and hypotension were more frequent with empagliflozin.