Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure
Abstract
This randomized controlled trial (EMPEROR-Reduced) evaluated the efficacy of empagliflozin a sodium-glucose cotransporter 2 (SGLT2) inhibitor in patients with chronic heart failure and a reduced ejection fraction (≤40%), regardless of diabetes status. A total of 3730 patients were randomized to receive empagliflozin (10 mg daily) or placebo, in addition to standard therapy. Over a median follow-up of 16 months, patients receiving empagliflozin experienced a significantly lower risk of the primary outcome (cardiovascular death or hospitalization for worsening heart failure) compared to placebo (hazard ratio: 0.75; 95% CI: 0.65–0.86; P<0.001). Empagliflozin also slowed the decline in estimated glomerular filtration rate and reduced the risk of serious renal outcomes. These benefits were consistent across subgroups, including patients with or without diabetes and those on sacubitril-valsartan. Genital tract infections were reported more often in the empagliflozin group, but other adverse events were similar between groups. The authors conclude that empagliflozin improves cardiorenal outcomes in this population, supporting its use across a broad spectrum of heart failure severity.
Keywords:
empagliflozin
heart failure
SGLT2 inhibitors
ejection fraction
hospitalization
renal outcomes
NT-proBNP
cardiovascular mortality
DAPA-HF comparison
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