EMPEROR-Preserved: Empagliflozin reduces risk for serious hospitalizations in HFpEF
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In patients with HF with preserved ejection fraction, empagliflozin reduced risk for serious hospitalizations compared with placebo, according to new data from the EMPEROR-Preserved trial.
As Healio previously reported, in the main results of EMPEROR-Preserved, patients with HFpEF with or without diabetes assigned the SGLT2 inhibitor empagliflozin (Jardiance, Boehringer Ingelheim/Eli Lilly) had a 21% reduced risk for CV death or HF hospitalization compared with placebo at a median follow-up of 26.2 months. Milton Packer, MD, Distinguished Scholar in Cardiovascular Science at Baylor University Medical Center and visiting professor at Imperial College London, presented results related to serious hospitalizations at the Heart Failure Society of America Annual Scientific Meeting. The data were simultaneously published in Circulation.
Risk for CV death, HF hospitalization or emergent/urgent HF visit requiring IV treatment was lower in the empagliflozin group (HR = 0.77; 95% CI, 0.67-0.87; P < .0001), and the benefit reached significance at 18 days, Packer said during a presentation.
The empagliflozin group also had reduced risk for HF hospitalizations requiring intensive care (HR = 0.71; 95% CI, 0.52-0.96; P = .028) and any hospitalization requiring a vasopressor or positive inotropic drug (HR = 0.73; 95% CI, 0.55-0.97; P = .033) compared with placebo, he said.
Outpatient intensification of diuretics was less common in the empagliflozin group compared with the placebo group (HR = 0.73; 95% CI, 0.65-0.82; P < .0001), Packer said.
Patients assigned empagliflozin were 20% to 50% more likely to improve in NYHA class compared with those assigned placebo, as early as 12 weeks and up to 2 years, according to the researchers.
“SGLT2 inhibition with empagliflozin produced a meaningful, early and sustained reduction in risk and severity of a broad range of inpatient and outpatient worsening heart failure events,” Packer said during the presentation. “These benefits include a decrease in the need for hospitalizations requiring aggressive therapy, a diminution of worsening events requiring intensification of diuretics and an increased likelihood of functional class improvement, effects that were maintained for more than 2 years.
“There is no effect on non-heart failure events. Patients with heart failure with preserved ejection fraction have lots of medical problems other than heart failure, and SGLT2 inhibitors really don’t treat those other medical problems, which is why you are still seeing hospitalizations for other cardiovascular reasons not related to heart failure or non-cardiovascular reasons, uninfluenced by therapy,” Packer said.
Reference:
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Packer M, et al. Late Breaking Clinical Trials I. Presented at: Heart Failure Society of America Annual Scientific Meeting; Sept. 10-13, 2021; Denver (hybrid meeting).
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