Heart failure & cardiomyopathies
Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights from the EMPEROR-Preserved Trial
Authors' conclusion
In EMPEROR-Preserved, empagliflozin had a beneficial effect on the key efficacy outcomes in patients with and without CKD. Overall, the benefit and safety of empagliflozin was consistent across a wide range of kidney function spectrum, down to a baseline eGFR of 20 ml/min/1.73 m2 .
Study context
- Population
- Patients with heart failure (HF) with preserved EF, with or without chronic kidney disease (CKD) (eGFR <60 ml/min/1.73 m² or urine albumin to creatinine ratio >300 mg/g)3,198 (53.5%) with CKD
- Participants
- 5,988 patients
- Comparison
- Empagliflozin vs placebo, by CKD status
- Primary endpoint
- Composite of:
- CV death
- First HF hospitalization
- Follow-up
- Median 26.2 months
Methodological detailspre-specified analysis
- Pre-specified analysis
Primary result
As reported in the abstract
CV death or first HF hospitalization, by CKD status
Empagliflozin vs PlaceboHazard ratio (95% CI)
With CKD
0.80(0.69–0.94)
Without CKD
0.75(0.60–0.95)
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| Total (first and recurrent) HF hospitalizations, by CKD statusEmpagliflozinvs PlaceboWith CKD | 0.68 (0.54–0.86) | |
| Total (first and recurrent) HF hospitalizations, by CKD statusEmpagliflozinvs PlaceboWithout CKD | 0.89 (0.66–1.21) | |
| Composite kidney outcome (sustained ≥40% eGFR decline, chronic dialysis or renal transplant), by CKD statusEmpagliflozinvs PlaceboWith CKD · pre-specified exploratory | 0.97 (0.71–1.34) | |
| Composite kidney outcome (sustained ≥40% eGFR decline, chronic dialysis or renal transplant), by CKD statusEmpagliflozinvs PlaceboWithout CKD · pre-specified exploratory | 0.92 (0.58–1.48) | |
| 0.512Hazard ratio (log scale) |
| Outcome | Difference (ml/min/1.73 m² /year) (CI) | |
|---|---|---|
| eGFR slope, by CKD statusEmpagliflozinvs PlaceboWith CKD; slower eGFR decline | 1.43 (1.01–1.85) | |
| eGFR slope, by CKD statusEmpagliflozinvs PlaceboWithout CKD; slower eGFR decline | 1.31 (0.88–1.74) | |
| −1012Difference, ml/min/1.73 m² /year (linear scale) |
- Total (first and recurrent) HF hospitalizations, by CKD status: interaction p = 0.17
- eGFR slope, by CKD status: interaction p = 0.70
- Composite kidney outcome (sustained ≥40% eGFR decline, chronic dialysis or renal transplant), by CKD status: interaction p = 0.86
Composite kidney outcome (sustained ≥40% eGFR decline, chronic dialysis or renal transplant), by CKD status
- Slowed progression to macroalbuminuria and reduced risk of AKI
Primary and key secondary outcomes across five baseline eGFR categories
- Consistent effect across eGFR categories
- all interaction p >0.05
Original publication
Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights from the EMPEROR-Preserved Trial. Eur J Heart Fail. Published 4 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →