Heart failure & cardiomyopathies

Recency of Heart Failure Hospitalization, Outcomes, and the Effect of Empagliflozin: An EMPEROR-Pooled Analysis

JACC Heart FailPublished Secondary analysis of the EMPEROR-Pooled randomised trials

Authors' conclusion

Patients with a recent HF hospitalization have a high risk of events. Empagliflozin reduced HF events regardless of HF hospitalization recency.

Study context

Population
Heart failure (HF) patients grouped by recency of HF hospitalization (none, <3 months, 3–6 months, 6–12 months, >12 months)
Participants
9,718 patients
Comparison
Empagliflozin vs placebo, by recency of prior HF hospitalization
Primary endpoint
Composite of:
  • Time to first HF hospitalization
  • CV death
Follow-up
Median 21 months
Methodological detailssubgroup analysis by recency of HF hospitalization, pooled EMPEROR-Reduced and EMPEROR-Preserved
  • Subgroup analysis by recency of HF hospitalization
  • Pooled EMPEROR-Reduced and EMPEROR-Preserved

Primary result

As reported in the abstract

HF hospitalization or CV death, by recency of HF hospitalization
Placebo event rate, hospitalized <3 months (per 100 person-years)
26.7
Placebo event rate, hospitalized 3-6 months (per 100 person-years)
18.1
Placebo event rate, hospitalized 6-12 months (per 100 person-years)
13.7
Placebo event rate, hospitalized >12 months (per 100 person-years)
2.8
Relative risk reduction with empagliflozin similar across HF hospitalization categories
P interaction = 0.67
Absolute risk reduction, hospitalized <3 months (events per 100 person-years)
−6.9
Absolute risk reduction, hospitalized 3-6 months (events per 100 person-years)
−5.5
Absolute risk reduction, hospitalized 6-12 months (events per 100 person-years)
−0.8
Absolute risk reduction, hospitalized >12 months (events per 100 person-years)
−0.6
Absolute risk reduction, no prior HF hospitalization (events per 100 person-years)
−2.4
No statistical heterogeneity of absolute risk reduction
P interaction = 0.64

Safety

Empagliflozin safe irrespective of HF hospitalization recency

Original publication

Recency of Heart Failure Hospitalization, Outcomes, and the Effect of Empagliflozin: An EMPEROR-Pooled Analysis. JACC Heart Fail. Published 20 February 2023. doi:10.1016/j.jchf.2023.01.018

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