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Treatment effects of empagliflozin in hospitalized heart failure patients across the range of left ventricular ejection fraction - Results from the EMPULSE trial.
- Source :
-
European journal of heart failure [Eur J Heart Fail] 2024 Apr; Vol. 26 (4), pp. 963-970. Date of Electronic Publication: 2024 Apr 04. - Publication Year :
- 2024
-
Abstract
- Aim: The EMPULSE (EMPagliflozin in patients hospitalised with acUte heart faiLure who have been StabilizEd) trial showed that, compared to placebo, the sodium-glucose cotransporter 2 inhibitor empagliflozin (10 mg/day) improved clinical outcomes of patients hospitalized for acute heart failure (HF). We investigated whether efficacy and safety of empagliflozin were consistent across the spectrum of left ventricular ejection fraction (LVEF).<br />Methods and Results: A total of 530 patients hospitalized for acute de novo or decompensated HF were included irrespective of LVEF. For the present analysis, patients were classified as HF with reduced (HFrEF, LVEF ≤40%), mildly reduced (HFmrEF, LVEF 41-49%) or preserved (HFpEF, LVEF ≥50%) ejection fraction at baseline. The primary endpoint was a hierarchical outcome of death, worsening HF events (HFE) and quality of life over 90 days, assessed by the win ratio. Secondary endpoints included individual components of the primary endpoint and safety. Out of 523 patients with baseline data, 354 (67.7%) had HFrEF, 54 (10.3%) had HFmrEF and 115 (22.0%) had HFpEF. The clinical benefit (hierarchical composite of all-cause death, HFE and Kansas City Cardiomyopathy Questionnaire total symptom score) of empagliflozin at 90 days compared to placebo was consistent across LVEF categories (≤40%: win ratio 1.35 [95% confidence interval 1.04, 1.75]; 41-49%: win ratio 1.25 [0.66, 2.37)] and ≥50%: win ratio 1.40 [0.87, 2.23], p <subscript>interaction</subscript> = 0.96) with a favourable safety profile. Results were consistent across individual components of the hierarchical primary endpoint.<br />Conclusion: The clinical benefit of empagliflozin proved consistent across LVEF categories in the EMPULSE trial. These results support early in-hospital initiation of empagliflozin regardless of LVEF.<br /> (© 2024 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
- Subjects :
- Humans
Male
Female
Aged
Treatment Outcome
Middle Aged
Quality of Life
Double-Blind Method
Benzhydryl Compounds therapeutic use
Glucosides therapeutic use
Stroke Volume physiology
Heart Failure drug therapy
Heart Failure physiopathology
Sodium-Glucose Transporter 2 Inhibitors therapeutic use
Hospitalization statistics & numerical data
Ventricular Function, Left physiology
Ventricular Function, Left drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0844
- Volume :
- 26
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- European journal of heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 38572654
- Full Text :
- https://doi.org/10.1002/ejhf.3218