Heart failure & cardiomyopathies
Uric Acid and SGLT2 Inhibition With Empagliflozin in Heart Failure With Preserved Ejection Fraction: The EMPEROR-Preserved Trial
Primary result · SUA change with empagliflozin and treatment benefit by baseline SUAResult — go to the resultDifference −0.99 mg/dLAuthors' conclusion
Hyperuricemia is a common complication in HFpEF and is related to advanced disease severity and adverse outcome. Empagliflozin induced a rapid and sustained reduction of SUA levels and of clinical events related to hyperuricemia.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF)
- Comparison
- Empagliflozin vs placebo; Serum uric acid (SUA) levels in relation to outcomes
- Primary endpoint
- Effect of empagliflozin on SUA in relation to therapeutic efficacy (trial primary outcome: CV mortality or HF hospitalization)
Primary result
As reported in the abstract
SUA change with empagliflozin and treatment benefit by baseline SUA
Difference
−0.99 mg/dL
P < 0.0001
- Treatment benefit on primary endpoint not influenced by baseline SUA
- HR: 0.79 [95% CI: 0.69-0.90]; P = 0.0004
- Change in SUA an independent correlate of treatment benefit on primary endpoint
- P = 0.07
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Elevated SUA (highest tertile, 8.8 ± 1.4 g/dL) and outcomes — Highest SUA tertile vs Placebo · primary endpoint | 1.23 (0.98–1.53) | P = 0.07 | |
| Elevated SUA (highest tertile, 8.8 ± 1.4 g/dL) and outcomes — Highest SUA tertile vs Placebo · HF hospitalization | 1.42 (1.08–1.86) | P = 0.01 | |
| 0.512Hazard ratio (log scale) |
Hyperuricemia prevalence (SUA >5.7 mg/dL women, >7.0 mg/dL men)
- Prevalence of hyperuricemia
- 49%
Elevated SUA (highest tertile, 8.8 ± 1.4 g/dL) and outcomes
- Elevated SUA associated with advanced heart failure (HF) severity
Original publication
Uric Acid and SGLT2 Inhibition With Empagliflozin in Heart Failure With Preserved Ejection Fraction: The EMPEROR-Preserved Trial. JACC Heart Fail. Published 23 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it