Heart failure & cardiomyopathies
Angiotensin Pathways Under Therapy with Empagliflozin in Patients with Chronic Heart Failure
Authors' conclusion
Our data indicate that empagliflozin might lead to an activation of both the Ang I-ACE-Ang II receptor axis and the Mas-axis pathway.
Study context
- Population
- Patients with stable chronic heart failure (CHF) (NYHA II–III)
- Participants
- 72 patients
- Comparison
- Empagliflozin vs placebo
- Primary endpoint
- Change in RAS parameters (LC-MS/MS-based RAS profiles) from baseline
- Follow-up
- 1 month and 3 months
Methodological detailsplacebo-controlled
- Placebo-controlled
Primary result
As reported in the abstract
Angiotensin II (Ang-II), empagliflozin: baseline vs 3 months (pmol/L, median-range as printed)
68.5 (21.3-324.2) vs. 131.5 (34.9-564.0)
P = 0.001
Angiotensin-I (Ang-I), empagliflozin: baseline vs 3 months (pmol/L)
78.7 (21.5-236.6) vs. 125.9 (52.6-512.9)
P < 0.001
Ang-(1-7), empagliflozin: baseline vs 3 months (pmol/L)
3.0 (3.0-15.0) vs. 10.1 (3.0-31.3)
P = 0.006
Ang-(1-5), empagliflozin: baseline vs 3 months (pmol/L)
5.4 (2.0-22.9) vs. 9.9 (2.8-36.4)
P = 0.004
Further findings
Renin-angiotensin system (RAS) metabolites with empagliflozin, angiotensin-receptor-blocking (ARB) co-medication (subgroup) · baseline to 3 months
- Ang-II (pmol/L)
- 206.4 (64.2-750.6) vs. 568.2 (164.7-1616.4), P = 0.001
- Ang-(1-7) (pmol/L)
- 3.0 (3.0-14.1) vs. 15.0 (3.0-31.3), P = 0.017
- Ang-(1-5) (pmol/L)
- 12.2 (3.8-46.6) vs. 36.4 (11.1-90.7), P = 0.001
RAS metabolites with empagliflozin, ACEi co-medication (subgroup) · baseline to 3 months
- Ang-II (pmol/L), no change
- 16.7 (2.0-60.8) vs. 26.4 (10.7-63.4), P = 0.469
- Ang-(1-7) (pmol/L), no change
- 6.6 (3.0-20.7) vs. 10.5 (3.0-50.5), P = 0.221
- Ang-(1-5) (pmol/L), no change
- 2.7 (2.0-8.4) vs. 2.8 (2.0-6.9), P = 0.851
Original publication
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