Effects of Empagliflozin in Women and Men With Heart Failure and Preserved Ejection Fraction - Université de Lorraine Access content directly
Journal Articles Circulation Year : 2022

Effects of Empagliflozin in Women and Men With Heart Failure and Preserved Ejection Fraction

1 Baylor Scott and White Research Institute [Dallas, TX, USA]
2 UMMC - University of Mississippi Medical Center
3 NKUA - National and Kapodistrian University of Athens
4 “Attikon” University Hospital
5 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
6 CIC-P - Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
7 INI-CRCT - Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy]
8 Cardiovascular & Renal Clinical Trialists - CRCT - French-Clinical Research Infrastructure Network - F-CRIN [Paris]
9 FMUP - Faculdade de Medicina da Universidade do Porto
10 Boehringer Ingelheim International GmbH
11 Medizinische Fakultät Mannheim
12 USP - Universidade de São Paulo = University of São Paulo
13 Universität des Saarlandes [Saarbrücken]
14 UKS - Saarland University Hospital
15 Max Superspeciality Hospital, Saket
16 MUHC - McGill University Health Center [Montreal]
17 Boehringer Ingelheim Pharma GmbH & Co. KG
18 Massachusetts General Hospital [Boston, MA, USA]
19 Baim Institute for Clinical Research Boston MA
20 Cedars-Sinai Medical Center
21 CMU - Central Michigan University
22 Wrocław Medical University
23 Department of Cardiology, Charité University Medicine Berlin, Campus Benjamin-Franklin
24 DZHK - German Center for Cardiovascular Research
25 Feinberg School of Medicine
26 Hosp P Giovanni XXIII - Hospital Papa Giovanni XXIII
27 St. Michael's Hospital
28 Fuwai Hospital Chinese Academic of Medical Science
29 LSHTM - London School of Hygiene and Tropical Medicine
30 Baylor Heart and Vascular Institute, Baylor University Medical Center
31 Imperial College London
32 Charité Campus Virchow-Klinikum (CVK)
33 BCRT - Berlin-Brandenburg Center for Regenerative Medicine [Berlin, Germany]

Abstract

Background: Women and men with heart failure (HF) and preserved ejection fraction may differ in their clinical characteristics and their response to therapy. The aim of this study was to evaluate the influence of sex on the effects of empagliflozin in patients with HF and preserved ejection fraction enrolled in the EMPEROR-Preserved trial (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Preserved Ejection Fraction). Methods: The effects of empagliflozin on the primary outcome of cardiovascular death or hospitalization for HF and on secondary outcomes (including total HF hospitalization, cardiovascular and all-cause mortality, and Kansas City Cardiomyopathy Questionnaire scores) were compared in women and men in the overall cohort and in subgroups defined by left ventricular ejection fraction (41%-49%, 50%-59%, and ≥60%). The effects of empagliflozin on physiological measures, including changes in systolic blood pressure, uric acid, hemoglobin, body weight, and natriuretic peptide levels, were also assessed. Results: Of the 5988 patients randomized, 2676 (44.7%) were women. In the placebo arm, women tended to have lower risk for adverse outcomes, including a lower risk of all-cause mortality (hazard ratio, 0.69 [95% CI, 0.56, 0.84]). Compared with placebo, empagliflozin reduced the risk of cardiovascular death or hospitalization for HF to a similar degree in both sexes (hazard ratio, 0.81 [95% CI, 0.69, 0.96] for men; and hazard ratio, 0.75 [95% CI, 0.61, 0.92] for women; Pinteraction=0.54). Sex did not modify the relationship between empagliflozin and outcomes across ejection fraction groups. Similar results were seen for secondary outcomes and physiological measures. Compared with placebo, empagliflozin improved the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score to a similar extent in both sexes (1.38 for men versus 1.63 for women at 52 weeks; Pinteraction=0.77); the results were similar for Kansas City Cardiomyopathy Questionnaire overall summary score and total summary score. Conclusions: Empagliflozin produced similar benefits on outcomes and health status in women and men with HF and preserved ejection fraction.
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hal-03795027 , version 1 (03-10-2022)

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Javed Butler, Gerasimos Filippatos, Jamal Siddiqi, João Pedro Ferreira, Martina Brueckmann, et al.. Effects of Empagliflozin in Women and Men With Heart Failure and Preserved Ejection Fraction. Circulation, 2022, 146 (14), pp.1046-1055. ⟨10.1161/CIRCULATIONAHA.122.059755⟩. ⟨hal-03795027⟩
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