Heart failure & cardiomyopathiesSecondary analysis
Early Changes in Estimated Glomerular Filtration Rate Post-Initiation of Empagliflozin in EMPEROR-Preserved
- Secondary analysis of the EMPEROR-Preserved randomised trial
- landmark analysis
Authors' conclusion
Such small eGFR decrease was not associated with adverse cardiovascular outcomes with empagliflozin. In contrast, eGFR decrease was associated with poor cardiovascular outcomes with placebo.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) enrolled in EMPEROR-Preserved97.5% with initial eGFR change
- Participants
- 5,836 patients
- Comparison
- Empagliflozin vs placebo, by early eGFR change
- Primary endpoint
- Composite of:
- HF hospitalization or CV death (primary outcome)
- By early eGFR change levels
- Follow-up
- After week 4
Primary result
eGFR change from baseline to week 4 · week 4
Mean eGFR change
−3.2 ml/min/1.73 m²
As reported in the abstract
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Outcomes after week 4, placebo: tertile with most profound eGFR decrease (≥5.1%) vs tertile with eGFR increase — eGFR decrease ≥5.1% vs eGFR increase · primary outcome | 1.46 (1.17–1.82) | |
| Outcomes after week 4, placebo: tertile with most profound eGFR decrease (≥5.1%) vs tertile with eGFR increase — eGFR decrease ≥5.1% vs eGFR increase · CV mortality | 1.38 (1.01–1.89) | |
| Outcomes after week 4, placebo: tertile with most profound eGFR decrease (≥5.1%) vs tertile with eGFR increase — eGFR decrease ≥5.1% vs eGFR increase · sustained ≥50% eGFR decrease or ESRD | 2.20 (1.20–4.04) | |
| 0.20.5125Hazard ratio (log scale) |
Outcomes after week 4 by eGFR change tertile, empagliflozin
- Risk of primary outcome (HF hospitalization or CV death), CV and all-cause mortality, sustained ≥50% eGFR decrease or end-stage renal disease (ESRD) did not differ by eGFR change levels
Original publication
Early Changes in Estimated Glomerular Filtration Rate Post-Initiation of Empagliflozin in EMPEROR-Preserved. Eur J Heart Fail. Published 21 January 2024. doi:10.1002/ejhf.3136
Summarised from the published abstract; every number is checked against it