Heart failure & cardiomyopathiesSecondary analysis
Neutrophil-to-Lymphocyte Ratio in Patients With Heart Failure: Findings From The EMPEROR Program
- post-hoc analysis
Authors' conclusion
In patients with CHF, a higher NLR was associated with greater congestion and poorer prognosis. The efficacy of empagliflozin was consistent, regardless of baseline NLR.
Study context
- Population
- Patients with chronic heart failure (CHF) randomised to empagliflozin or placebo in the EMPEROR-Reduced and EMPEROR-Preserved trials, with neutrophil-to-lymphocyte ratio (NLR) available at baselinepatients with CHF randomised to empagliflozin or placebo with NLR available at baseline (EMPEROR-Pooled)
- Participants
- 9,706 patients
- Comparison
- highest NLR quintile vs lowest NLR quintile
- Primary endpoint
- Time to first heart failure hospitalisation or cardiovascular death
Primary result
As reported in the abstract
Adjusted hazard ratio
1.44
CI 1.16–1.80
P = 0.001
By group
highest NLR quintile vs lowest NLR quintile
adjusted hazard ratio 1.44 (CI 1.16–1.80); P = 0.001
Secondary outcomes
Baseline characteristics, highest vs lowest NLR quintile
- Highest quintile older, more likely to be men, more symptomatic, higher plasma NT-proBNP and more likely to be treated with loop diuretics
Effect of empagliflozin on primary and secondary endpoints by baseline NLR
- Baseline NLR did not modify the effect of empagliflozin on either primary and secondary endpoints
NLR during follow-up
- NLR increased during follow-up but this was not affected by empagliflozin
Original publication
Neutrophil-to-Lymphocyte Ratio in Patients With Heart Failure: Findings From The EMPEROR Program. ESC Heart Fail. Published 18 September 2026. doi:10.1093/eschf/xvag243
Summarised from the published abstract; every number is checked against it