Heart failure & cardiomyopathiesSecondary analysis
Empagliflozin in Heart Failure with Preserved Ejection Fraction with and without Atrial Fibrillation
- Secondary analysis of the EMPEROR-Preserved randomised trial
- pre-defined secondary analysis
Authors' conclusion
In patients with HF and ejection fraction >40%, empagliflozin reduced the risk of serious HF events and slowed the eGFR decline regardless of baseline AF.
Study context
- Population
- Patients with heart failure (HF) and left ventricular ejection fraction (LVEF) >40%, with and without baseline atrial fibrillation/flutter (AF) (any ECG before empagliflozin initiation or medical history)3,135 (52%) with baseline AF
- Participants
- 5,988 patients
- Comparison
- Empagliflozin vs placebo, by baseline AF
Primary result
As reported in the abstract
CV death or HF hospitalization, by baseline AF (subgroup) · median 26 months
Empagliflozin vs PlaceboHazard ratio (95% CI)
with AF
0.78(0.66–0.93)
without AF
0.78(0.64–0.95)
Secondary outcomes
| Outcome | HR (CI) | |
|---|---|---|
| Total HF hospitalizations, by baseline AF (subgroup) — Empagliflozin vs Placebo · with AF | 0.73 (0.57–0.94) | |
| Total HF hospitalizations, by baseline AF (subgroup) — Empagliflozin vs Placebo · without AF | 0.72 (0.54–0.95) | |
| 0.512Hazard ratio (log scale) |
| Outcome | difference (ml/min/1.73 m² /year) |
|---|---|
| Annual eGFR decline, by baseline AF (subgroup) — Empagliflozin vs Placebo · with AF | 1.368 |
| Annual eGFR decline, by baseline AF (subgroup) — Empagliflozin vs Placebo · without AF | 1.372 |
- Total HF hospitalizations, by baseline AF (subgroup): interaction p = 0.94
- Annual estimated glomerular filtration rate (eGFR) decline, by baseline AF (subgroup): interaction p = 0.99
Safety
Serious adverse events
- No increase in serious adverse events with empagliflozin vs placebo in patients with and without AF
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Empagliflozin in Heart Failure with Preserved Ejection Fraction with and without Atrial Fibrillation. Eur J Heart Fail. Published 8 May 2023. doi:10.1002/ejhf.2861
Summarised from the published abstract; every number is checked against it