Heart failure & cardiomyopathiesMeta-analysis
Body Mass Index and Cardiorenal Outcomes in the EMPEROR-Preserved Trial: Principal Findings and Meta-Analysis with the DELIVER Trial
- Secondary analysis of the EMPEROR-Preserved randomised trial, with meta-analysis with DELIVER
- subgroup analysis by baseline body mass index (BMI)
Authors' conclusion
Empagliflozin treatment resulted in broadly consistent cardiac effects across the range of BMI in patients with HFpEF.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) in EMPEROR-Preserved, by baseline BMI (<25, 25 to <30, 30 to <35, 35 to <40, ≥40 kg/m²)45% BMI ≥30 kg/m²
- Comparison
- Empagliflozin vs placebo across baseline BMI categories
- Outcome
- HHF or CV death
Pooled result
As reported in the abstract
HHF or CV death, by BMI category
Consistent effect of empagliflozin vs placebo across BMI categories, no formal interaction
p trend = 0.19
Further pooled results
Total HHF, by BMI category
- No difference in effect across BMI categories
- P for trend = 0.19
CV death, by BMI category
- No difference in effect across BMI categories
- P for trend = 0.20
Estimated glomerular filtration rate (eGFR) slope, by BMI category
- Slower decline with empagliflozin regardless of BMI, relative to placebo (range, ml/min/1.73 m²)
- 1.12-1.71
- Interaction
- P for trend = 0.85
- No overall impact on composite renal endpoint
Weight change difference (empagliflozin vs placebo), lowest to highest BMI category
- Difference, kg, lowest to highest BMI category
- −0.59, −1.48, −1.54, −0.87, and - 2.67
- Interaction
- P for trend = 0.016
HHF or CV death, meta-analysis with DELIVER, by BMI category
- Consistent effect of SGLT2i vs placebo across BMI categories
Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS), by BMI · 32 weeks
- Trend toward greater absolute benefit with empagliflozin at higher BMI
- P = 0.08
Original publication
Body Mass Index and Cardiorenal Outcomes in the EMPEROR-Preserved Trial: Principal Findings and Meta-Analysis with the DELIVER Trial. Eur J Heart Fail. Published 1 April 2024. doi:10.1002/ejhf.3221
Summarised from the published abstract; every number is checked against it