Heart failure & cardiomyopathiesSecondary analysis
Genitourinary tract infections and SGLT2 inhibitors in heart failure: an EMPEROR-Pooled analysis
- Secondary analysis of the EMPEROR-Pooled randomised trials
Authors' conclusion
Lower UTIs were relatively frequent in HF patients, whereas MGI and pyelonephritis/urosepsis were infrequent. SGLT2i increased the risk of lower UTI and MGI. Although UTI, but not MGI, were associated with a higher subsequent risk of death, the clinical benefits of SGLT2i were preserved regardless of genitourinary infection occurrence.
Study context
- Population
- Men and women with heart failure (HF) across the spectrum of EF
- Participants
- 9,718 men
- Comparison
- Empagliflozin vs placebo
- Primary endpoint
- Genitourinary infections, their association with outcomes, and the impact of empagliflozin
Primary result
As reported in the abstract
Genitourinary infections during follow-up (median 21 months)
Lower urinary tract infections (UTI)
757 (7.8%)
Mycotic genitourinary infections (MGI)
60 (0.6%)
Pyelonephritis/urosepsis
41 (0.4%)
Further findings
Effect of empagliflozin on genitourinary infections
- Higher risk of lower UTI and MGI (particularly balanitis in men) with empagliflozin vs placebo, but not pyelonephritis/urosepsis
Death after infection
- Risk of death increased after UTI, but not after MGI
HF hospitalization or CV death
- Effect of empagliflozin vs placebo not modified by occurrence of genitourinary infections
Original publication
Genitourinary tract infections and SGLT2 inhibitors in heart failure: an EMPEROR-Pooled analysis. Eur J Heart Fail. Published 28 February 2026. doi:10.1093/ejhf/xuag054
Summarised from the published abstract; every number is checked against it