Heart failure & cardiomyopathies
Efficacy and Safety of Empagliflozin According to Background Diuretic Use in Heart Failure with Reduced Ejection Fraction (HFrEF): Post-Hoc Analysis of EMPEROR-Reduced
Authors' conclusion
Empagliflozin exhibits a consistent effect on time to CV death or HF hospitalization and an unaltered safety profile regardless of baseline diuretic therapy.
Study context
- Population
- Patients with HFrEF in the EMPEROR-Reduced trial3,656 analysed
- Participants
- 3,730 patients
- Comparison
- Empagliflozin 10 mg vs placebo, by background diuretic dose
- No diureticn = 482
- <40 mgn = 731
- 40 mgn = 1,411
- >40 mgn = 1,032
- Primary endpoint
- Time to first event of hospitalization for heart failure (HF) or CV death
Methodological detailsdouble-blind, placebo-controlled, subgroup analysis by baseline diuretic dose
- Double-blind
- Placebo-controlled
- Subgroup analysis by baseline diuretic dose
Primary result
As reported in the abstract
Hospitalization for HF or CV death, by baseline diuretic dose
Empagliflozin vs PlaceboHazard ratio (95% CI)
>40 mg
0.88(0.71–1.10)
40 mg
0.65(0.51–0.82)
<40 mg
0.65(0.46–0.92)
No diuretic
0.78(0.47–1.29)
- Effect consistent regardless of background diuretic therapy
- Ptrend test = 0.192
Further findings
Body weight, SBP, NT-proBNP, hematocrit · 52 weeks
- Baseline diuretic dose did not influence empagliflozin's effect
Safety
Safety profile / adverse events
- Safety profile of empagliflozin vs placebo unaffected by baseline diuretic dose
- Total AE rates higher with higher baseline diuretic doses, independent of treatment allocation
Original publication
Efficacy and Safety of Empagliflozin According to Background Diuretic Use in HFrEF: Post-Hoc Analysis of EMPEROR-Reduced. JACC Heart Fail. Published 13 September 2023. doi:10.
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