SGLT2 Inhibition in Heart Failure with a Preserved Ejection Fraction — A Win against a Formidable Foe

This editorial reviews findings from the EMPEROR-Preserved trial, which examined the effects of SGLT2 inhibitors—originally developed for type 2 diabetes—on patients with heart failure with preserved ejection fraction (HFpEF). Empagliflozin significantly reduced the composite risk of cardiovascular death or hospitalization for heart failure (hazard ratio 0.79), mainly due to reduced hospitalizations. The effect was consistent across patients regardless of diabetes status and ejection fraction range, though the benefit may diminish at higher ejection fractions. While renal benefits were more pronounced in patients with reduced ejection fraction, the trial still marks a turning point in HFpEF management, positioning SGLT2 inhibitors as promising therapeutic agents and paving the way for future trials like DELI

This editorial reviews findings from the EMPEROR-Preserved trial, which examined the effects of SGLT2 inhibitors—originally developed for type 2 diabetes—on patients with heart failure with preserved ejection fraction (HFpEF). Empagliflozin significantly reduced the composite risk of cardiovascular death or hospitalization for heart failure (hazard ratio 0.79), mainly due to reduced hospitalizations. The effect was consistent across patients regardless of diabetes status and ejection fraction range, though the benefit may diminish at higher ejection fractions. While renal benefits were more pronounced in patients with reduced ejection fraction, the trial still marks a turning point in HFpEF management, positioning SGLT2 inhibitors as promising therapeutic agents and paving the way for future trials like DELI