Heart failure & cardiomyopathies
Liver Tests, Cardiovascular Outcomes and Effects of Empagliflozin in Patients with Heart Failure and Preserved Ejection Fraction: The EMPEROR-Preserved Trial
Authors' conclusion
Abnormalities of liver function tests are associated differently with heart failure outcomes. Salutary effects of empagliflozin on liver tests were not observed although albumin increased. The treatment benefits of empagliflozin were not affected by baseline values of liver parameters.
Study context
- Population
- Heart failure with preserved ejection fraction (HFpEF) (EF >40%), NYHA class II–IV, elevated NT-proBNP; significant liver disease excluded
- Participants
- 5,988 participants
- Comparison
- Empagliflozin vs placebo across liver test categories
- Primary endpoint
- Time to first adjudicated hospitalization for heart failure (HHF) or CV death
Methodological detailsdouble-blind, placebo-controlled
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Association of liver tests with HHF or CV death (placebo)
- High alkaline phosphatase associated with poorer outcomes
- p trend < 0.0001
- Low albumin associated with poorer outcomes
- p trend < 0.0001
- High bilirubin associated with poorer outcomes
- p = 0.02
Further findings
Effects of empagliflozin on liver tests
- No significant effects on liver tests vs placebo except albumin, which was significantly increased
Original publication
Liver Tests, Cardiovascular Outcomes and Effects of Empagliflozin in Patients with Heart Failure and Preserved Ejection Fraction: The EMPEROR-Preserved Trial. Eur J Heart Fail. Published 27 June 2023. doi:10.
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