Heart failure & cardiomyopathiesSecondary analysis
Growth Differentiation Factor-15 and the Effect of Empagliflozin in Heart Failure: Findings from the EMPEROR Program
- Secondary analysis of the EMPEROR-Reduced and EMPEROR-Preserved randomised trials
Authors' conclusion
Growth differentiation factor-15 is a marker of worse heart failure severity, is an independent predictor of major heart failure outcomes and may be associated with more pronounced benefits of empagliflozin. GDF-15 is increased among metformin users, and empagliflozin was associated with an increase in GDF-15 levels, primarily in patients not receiving metformin.
Study context
- Population
- Patients with HFrEF or HFpEF in the EMPEROR-Reduced and EMPEROR-Preserved trials
- Participants
- 1,124 patients
- Comparison
- Empagliflozin vs placebo; GDF-15 levels
- Empagliflozinn = 564
- Placebon = 560reference
Primary result
As reported in the abstract
Adjusted hazard ratio
1.40
95% CI 1.15–1.71
P < 0.001
Each doubling in GDF-15, as printed
- Baseline median GDF-15 2442 pg/ml (IQR 1603-3780)
- 2442
Further findings
| Outcome | additional increase (%) | P value |
|---|---|---|
| Change in GDF-15, empagliflozin vs placebo · week 52 · primarily in patients not receiving metformin | 8 | P = 0.020 |
Effect of empagliflozin on CV death and HF hospitalization by baseline GDF-15
- Most pronounced in patients with higher baseline GDF-15
- interaction p-trend = 0.031
Correlation of baseline GDF-15 with IGF-binding protein 7
- rho
- 0.64
Original publication
Summarised from the published abstract; every number is checked against it