Empagliflozin and risk of lower respiratory tract infection in heart failure with mildly reduced and preserved ejection fraction: An EMPEROR‐Preserved analysis - Université de Lorraine Accéder directement au contenu
Article Dans Une Revue European Journal of Heart Failure Année : 2024

Empagliflozin and risk of lower respiratory tract infection in heart failure with mildly reduced and preserved ejection fraction: An EMPEROR‐Preserved analysis

Résumé

Aims Lower respiratory tract infections (LRTI) are common worldwide. Patients with heart failure and mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) have a high risk of developing LRTI. Prior studies were able to show that sodium–glucose cotransporter 2 inhibitors may reduce the incidence of LRTI in patients with type 2 diabetes. The aim of this study was to evaluate patient characteristics and prognosis according to LRTI status and to assess the effect of empagliflozin on LRTI in 5988 patients with HFmrEF/HFpEF enrolled in the EMPEROR‐Preserved trial randomized to either empagliflozin or placebo over a median follow‐up of 26 months. Methods and results Time‐updated models were used to study the mortality risk after a LRTI. Cox regression was used to study the effect of empagliflozin on incident LRTI. Throughout the follow‐up, 699 of 5988 (11.7%) patients developed LRTI: these were older, were more frequently hospitalized within the previous year, had type 2 diabetes, chronic kidney disease, and had higher N‐terminal pro‐B‐type natriuretic peptide levels than patients without incident LRTI. Patients who developed LRTI had a 2.7‐fold higher risk of subsequent mortality compared to patients without LRTI. The incidence of LRTI was 5.2 (95% confidence interval [CI] 4.6–5.8) events per 100 person‐years in the empagliflozin group and 6.2 (95% CI 5.6–6.9) events per 100 person‐years in the placebo group (hazard ratio 0.83, 95% CI 0.71–0.96, p = 0.014). The total number of LRTI events was reduced in the empagliflozin group (incidence rate ratio 0.80, 95% CI 0.68–0.94, p = 0.008). No effect of empagliflozin was observed on COVID‐19 incidence. Conclusion In EMPEROR‐Preserved, LRTI was frequent and associated with a poor prognosis. Empagliflozin was associated with a reduced risk of LRTI compared to placebo.
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Année Mois Jours
Avant la publication
jeudi 5 septembre 2024
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jeudi 5 septembre 2024
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Dates et versions

hal-04496351 , version 1 (08-03-2024)

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João Pedro Ferreira, Faiez Zannad, Milton Packer, Gerasimos Filippatos, Stuart Pocock, et al.. Empagliflozin and risk of lower respiratory tract infection in heart failure with mildly reduced and preserved ejection fraction: An EMPEROR‐Preserved analysis. European Journal of Heart Failure, inPress, ⟨10.1002/ejhf.3180⟩. ⟨hal-04496351⟩
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