Empagliflozin benefits consistent regardless of timing of HF hospitalization
Click Here to Manage Email Alerts
NEW ORLEANS — The benefits of empagliflozin in patients with HF were consistent regardless of the recency of a patient’s HF hospitalization, researchers reported at the American College of Cardiology Scientific Session.
João Pedro Ferreira, MD, PhD, professor of medicine at the University of Porto, Portugal, analyzed 9,718 patients from the EMPEROR-Pooled cohort, which included patients with HF with reduced ejection fraction enrolled in EMPEROR-Reduced and patients with HF with preserved EF enrolled in EMPEROR-Preserved. In both trials, patients were assigned empagliflozin (Jardiance, Boehringer Ingelheim/Eli Lilly) or placebo.
“The early postdischarge period ([about] 3 months) after a HF hospitalization is often referred to as the ‘vulnerable phase’ where the risk of event recurrence is highest,” the researchers wrote in a simultaneous publication in JACC: Heart Failure. “Interventions within the ‘vulnerable phase’ may have a substantial impact on patient’s outcomes. ... We aim to study the prognostic associations and the effect of empagliflozin (vs. placebo) according to the timing since prior HF hospitalization.”
Patients were stratified by recency of HF hospitalization before enrollment: none, less than 3 months, 3 to 6 months, 6 to 12 months or more than 12 months.
The primary outcome was time to first event of HF hospitalization or CV death. Median follow-up was 21 months.
In the placebo group, the event rates of the primary outcome were 26.7 per 100 person-years for patients with HF hospitalization less than 3 months before enrollment, 18.1 per 100 person-years for patients with HF hospitalization 3 to 6 months before enrollment, 13.7 per 100 person-years for patients with HF hospitalization 6 to 12 months before enrollment and 2.8 per 100 person-years for patients with HF hospitalization more than 12 months before enrollment, according to the researchers.
The relative risk reduction of primary outcome events associated with empagliflozin was similar across all HF hospitalization groups (P for interaction = .67), Ferreira and colleagues found.
The absolute risk reduction of primary outcome events associated with empagliflozin was more pronounced in those with a more recent HF hospitalization, but not to the extent of statistical significance (< 3 months, –6.9 events prevented per 100 person-years; 3 to 6 months, –5.5 events prevented per 100 person-years; 6 to 12 months, –0.8 events prevented per 100 person-years; > 12 months, –0.6 events prevented per 100 person-years; no previous HF hospitalization, –2.4 events prevented per 100 person-years; P for interaction = .64), according to the researchers.
Safety events in patients assigned empagliflozin were low and similar between HF hospitalization groups, Ferreira and colleagues found.
“Patients with a recent HF hospitalization, particularly if occurring within the previous 3 months, have a high risk of HF re-hospitalization and mortality and experience large absolute benefit from empagliflozin treatment,” the researchers wrote in the simultaneous publication. “These findings underscore the importance of initiating empagliflozin as early as possible within or early after a HF hospitalization, if not possible to initiate treatment to prevent a first HF hospitalization.”
Reference:
Collapse
Ferreira JP, et al. Abstract 1005-11. Presented at: American College of Cardiology Scientific Session; March 4-6, 2023; New Orleans (hybrid meeting).
Click Here to Manage Email Alerts