Efficacy of empagliflozin in heart failure with preserved versus mid-range ejection fraction: a pre-specified analysis of EMPEROR-Preserved - Université de Lorraine Access content directly
Journal Articles Nature Medicine Year : 2022

Efficacy of empagliflozin in heart failure with preserved versus mid-range ejection fraction: a pre-specified analysis of EMPEROR-Preserved

1 Wrocław Medical University
2 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
3 Baylor Scott and White Research Institute [Dallas, TX, USA]
4 Mississippi State University [Mississippi]
5 UMMC - University of Mississippi Medical Center
6 University of Athens Medical School [Athens]
7 CIC-P - Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
8 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
9 INI-CRCT - Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy]
10 Universidade do Porto = University of Porto
11 USP - Universidade de São Paulo = University of São Paulo
12 UKS - Saarland University Hospital
13 CARIM - Cardiovascular Research Institute Maastricht
14 MUMC - Maastricht University Medical Centre
15 SNUBH - Seoul National University Bundang Hospital
16 MSH - MAX Superspecialty Hospital [Saket, New Delhi, India]
17 National Institute of Cardiology, Mexico City
18 MUHC - McGill University Health Center [Montreal]
19 ICESI - Universidad Icesi
20 University Hospitals Leuven [Leuven]
21 Massachusetts General Hospital [Boston]
22 Baim Institute for Clinical Research Boston MA
23 CIBERCV - Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares [Spain]
24 Semmelweis University [Budapest]
25 Monash University [Melbourne]
26 UCA - Pontifical Catholic University of Argentina
27 FLENI - Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia [Buenos Aires]
28 CMU - Central Michigan University
29 Hosp P Giovanni XXIII - Hospital Papa Giovanni XXIII
30 NHCS - National Heart Centre Singapore
31 MUNI - Masaryk University [Brno]
32 St. Anne’s University Hospital [Brno]
33 University of Leicester
34 University of Pisa - Università di Pisa
35 Kyushu University
36 St. Michael's Hospital
37 University of Toronto
38 University Emergency Hospital [Bucharest]
39 UMPCD - University of Medicine and Pharmacy “Carol Davila” Bucharest
40 PUMCH - Peking Union Medical College Hospital [Beijing]
41 Boehringer Ingelheim Pharma GmbH & Co. KG
42 Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield
43 Boehringer Ingelheim International GmbH
44 Universität Heidelberg [Heidelberg] = Heidelberg University
45 LSHTM - London School of Hygiene and Tropical Medicine
Bela Merkely
Ileana L Piña

Abstract

The EMPEROR-Preserved trial showed that the sodium–glucose co-transporter 2 inhibitor empagliflozin significantly reduces the risk of cardiovascular death or hospitalization for heart failure (HHF) in heart failure patients with left ventricular ejection fraction (LVEF) > 40%. Here, we report the results of a pre-specified analysis that separately evaluates these patients stratified by LVEF: preserved (≥ 50%) ( n = 4,005; 66.9%) or mid-range (41–49%). In patients with LVEF ≥ 50%, empagliflozin reduced the risk of cardiovascular death or HHF (the primary endpoint) by 17% versus placebo (hazard ratio (HR) 0.83; 95% confidence interval (CI): 0.71–0.98, P = 0.024). For the key secondary endpoint, the HR for total HHF was 0.83 (95%CI: 0.66–1.04, P = 0.11). For patients with an LVEF of 41–49%, the HR for empagliflozin versus placebo was 0.71 (95%CI: 0.57–0.88, P = 0.002) for the primary outcome ( P interaction = 0.27), and 0.57 (95%CI: 0.42–0.79, P < 0.001) for total HHF ( P interaction = 0.06). These results, together with those from the EMPEROR-Reduced trial in patients with LVEF < 40%, support the use of empagliflozin across the full spectrum of LVEF in heart failure.
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Dates and versions

hal-03886069 , version 1 (06-12-2022)

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Stefan D Anker, Javed Butler, Muhammad Shariq Usman, Gerasimos Filippatos, João Pedro Ferreira, et al.. Efficacy of empagliflozin in heart failure with preserved versus mid-range ejection fraction: a pre-specified analysis of EMPEROR-Preserved. Nature Medicine, 2022, 28 (12), pp.2512-2520. ⟨10.1038/s41591-022-02041-5⟩. ⟨hal-03886069⟩
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