EMPEROR‑Preserved – Empagliflozin a kardiovaskulární příhody u pacientů se srdečním selháním a zachovalou ejekční frakcí.

Background: Sodium-glucose cotransporter 2 inhibitors reduce the risk of hospitalisations for heart failure and reduced ejection fraction, but their effects in patients with heart failure and preserved ejection fraction are uncertain. The EMPEROR-Preserved study tested the effect of empagliflozin in patients with preserved ejection fraction. Methods: In this double-blind trial, we randomly assigned 5,988 patients with NYHA class II-IV heart failure and an ejection fraction > 40% to receive empagliflozin (10 mg once daily) or placebo in addition to recommended therapy. The primary outcome was a composite of cardiovascular death and hospitalisation for heart failure. Results: The median follow-up was 26.2 months, and the primary outcome occurred in 415 of 2,997 patients (13.8%) in the empagliflozin group and in 511 of 2,991 patients (17.1%) in the placebo group (p < 0.001). This effect was mainly related to a 29% decrease in the risk of hospitalisation for heart failure. The effect of empagliflozin on the primary outcome was consistent in patients with an ejection fraction < 50%, 50% to 60%, and ≥ 60%, regardless of the presence or absence of diabetes mellitus. The total number of hospitalisations for heart failure was lower in the empagliflozin group than in the placebo group (p < 0.001). The mortality rate was not affected. Conclusion: Empagliflozin reduced the hospitalisation rate for heart failure in patients with heart failure and preserved ejection fraction, regardless of the presence or absence of diabetes mellitus. [ABSTRACT FROM AUTHOR]