Heart failure & cardiomyopathiesMeta-analysis
Kidney function decline, heart failure hospitalization, and the effect of empagliflozin in heart failure: an EMPEROR-pooled analysis
- Pooled analysis of trials
- EMPEROR-Reduced and EMPEROR-Preserved trials
Authors' conclusion
Across the LVEF spectrum, kidney function decline accelerated before HF-related events and remained rapid thereafter. Empagliflozin attenuated eGFR decline without evidence of heterogeneity across periods.
Study context
- Population
- Patients with heart failure (HF) across the LVEF spectrum (EMPEROR-Reduced and EMPEROR-Preserved trials)
- Participants
- 9,554 patients
- Comparison
- Empagliflozin vs placebo
- Outcome
- Longitudinal changes in eGFR before and after HF-related events (HF hospitalization or HF-related death)
- Follow-up
- Median 20.9 months (14.7-28.6)
Pooled result
As reported in the abstract
Difference in eGFR decline (empagliflozin vs placebo)
Between-group difference, ml/min/1.73 m²/year
- in patients without events
- 0.94
- before events
- 1.09
- post-eventThe post-event difference was smaller
- 0.29
Further pooled results
Average, ml/min/1.73 m²/year
| Outcome | HF-related events | No HF-related events | P value |
|---|---|---|---|
| eGFR decline during 12 months before HF-related event · steeper eGFR decline during the 12 months before the event | −5.01 | −1.93 | P < 0.001 |
- Estimated glomerular filtration rate (eGFR) decline during 12 months before HF-related event: not materially altered after adjustment for concurrent NYHA class or natriuretic peptide levels
HF-related events · median follow-up 20.9 months (14.7-28.6)
- HF-related events (HF hospitalization or HF-related death)
- 12.7%
eGFR decline during 12 months after HF-related events
- Average rate of eGFR decline
- −4.73 ml/min/1.73 m²/year
Original publication
Kidney function decline, heart failure hospitalization, and the effect of empagliflozin in heart failure: an EMPEROR-pooled analysis. Eur J Heart Fail. Published 6 October 2026. doi:10.1093/ejhf/xuag295
Summarised from the published abstract; every number is checked against it