Secondary analysis
Left Ventricular Function, Congestion, and Effect of Empagliflozin on Heart Failure Risk After Myocardial Infarction
- Secondary analysis of the EMPACT-MI randomised trial
- placebo-controlled
Authors' conclusion
In patients with AMI, the severity of left ventricular dysfunction and the presence of congestion was associated with worse outcomes. Empagliflozin reduced first and total HF hospitalizations across the range of LVEF with and without congestion.
Study context
- Population
- Patients within 14 days of acute MI complicated by newly reduced left ventricular ejection fraction (LVEF) <45%, congestion, or both
- Participants
- 6,522 patients
- Comparison
- Empagliflozin vs placebo, by baseline LVEF and congestion
Primary result
As reported in the abstract
Outcomes by LVEF and congestion; empagliflozin effect on HF hospitalization · median 17.9 months
Estimate (95% CI)P value
Each 10-point LVEF reductionall-cause death or HF hospitalization; placebo arm, multivariable adjusted
HR 1.49(1.31–1.69)
P < 0.0001Each 10-point LVEF reductionfirst HF hospitalization; placebo arm
HR 1.64(1.37–1.96)
P < 0.0001Each 10-point LVEF reductiontotal HF hospitalizations (rate ratio); placebo arm
RR 1.89(1.51–2.36)
P < 0.0001Empagliflozin vs Placebofirst HF hospitalization
HR 0.77(0.60–0.98)
Empagliflozin vs Placebototal HF hospitalizations (rate ratio)
RR 0.67(0.50–0.89)
- Congestion vs Placebo · all-cause death or heart failure (HF) hospitalization; placebo arm
- HR 1.52
- Congestion vs Placebo · first HF hospitalization; placebo arm
- HR 1.94
- Congestion vs Placebo · total HF hospitalizations (rate ratio); placebo arm
- RR 2.03
Safety
Safety profile
- Safety of empagliflozin consistent across baseline LVEF and irrespective of congestion status
Original publication
Left Ventricular Function, Congestion, and Effect of Empagliflozin on Heart Failure Risk After Myocardial Infarction. J Am Coll Cardiol. Published 6 April 2024. doi:10.1016/j.jacc.2024.03.405
Summarised from the published abstract; every number is checked against it