Empagliflozin in Heart Failure with a Preserved Ejection Fractio

This randomized, double-blind trial (EMPEROR-Preserved) assessed empagliflozin versus placebo in 5988 patients with class II–IV heart failure and a left ventricular ejection fraction >40%. Over a median follow-up of 26.2 months, the empagliflozin group had a significantly lower rate of cardiovascular death or hospitalization for heart failure (13.8% vs. 17.1%; HR 0.79; P<0.001), driven largely by reduced hospitalizations. The benefit was consistent across subgroups including patients with or without diabetes. Secondary outcomes showed fewer total heart failure hospitalizations (HR 0.73) and slower eGFR decline. Adverse events were comparable between groups, though genital/urinary infections and hypotension were more frequent with empagliflozin. The results suggest empagliflozin offers therapeutic benefit for heart failure with preserved ejection fraction.

This randomized, double-blind trial (EMPEROR-Preserved) assessed empagliflozin versus placebo in 5988 patients with class II–IV heart failure and a left ventricular ejection fraction >40%. Over a median follow-up of 26.2 months, the empagliflozin group had a significantly lower rate of cardiovascular death or hospitalization for heart failure (13.8% vs. 17.1%; HR 0.79; P<0.001), driven largely by reduced hospitalizations. The benefit was consistent across subgroups including patients with or without diabetes. Secondary outcomes showed fewer total heart failure hospitalizations (HR 0.73) and slower eGFR decline. Adverse events were comparable between groups, though genital/urinary infections and hypotension were more frequent with empagliflozin. The results suggest empagliflozin offers therapeutic benefit for heart failure with preserved ejection fraction.