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Empagliflozin effects in patients with heart failure

Empagliflozin effects in patients with heart failure

Sodium-glucose co-transporter 2 (SGLT2) inhibitors have shown reduction in hospitalisation for heart failure (HHF) and serious adverse renal events risks, beyond their glucose-lowering benefits. More specifically, patients with type 2 diabetes who received SGLT2 inhibitors in large-scale, randomised, placebo-controlled trials experienced a 30% to 35% lower risk of HHF compared with patients who received placebo, even though most of them did not have a history of heart failure at baseline.

In this publication the authors report the results of the Empagliflozin Outcome Trial in Patients with Chronic Heart Failure and a Reduced Ejection Fraction (EMPEROR-Reduced) which evaluated the effects of empagliflozin in 3730 patients (with or without diabetes) with Class II, III or IV heart failure and a reduced ejection fraction of 40% or less. Patients were randomised to receive the SGLT2i empagliflozin (10 mg once daily) or placebo, in addition to recommended therapy.

Overall, empagliflozin favourably influenced the composite primary outcome of cardiovascular deaths or hospitalisation for worsening of heart failure with a hazard ratio of 0.75 (95% CI, 0.65-0.86, P<0.001) regardless of the presence or absence of diabetes. The combined relative risk reduction of 25% for the primary composite endpoint was primarily related to a 31% lower risk of HHF (HR 0.69, 95% CI 0.59-0.81).

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Editorial Board

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Dr. Salvatore A. De Cosmo's image

Dr. Salvatore A. De Cosmo

Head of Unit of Internal Medicine and Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza” San Giovanni, Rotondo, Italy
,
Image
Dr. Juan José Gorgojo Martínez's image

Dr. Juan José Gorgojo Martínez

Head of Department of Endocrinology and Nutrition, University Hospital Fundación, Alcorcon, Madrid, Spain
,
Image
Dr. Patrick Holmes' image

Dr. Patrick Holmes

General Practitioner, St. George's Medical Practice, Darlington, UK

Editorial Board

Image
Dr. Salvatore A. De Cosmo's image

Dr. Salvatore A. De Cosmo

Head of Unit of Internal Medicine and Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza” San Giovanni, Rotondo, Italy
Image
Dr. Juan José Gorgojo Martínez's image

Dr. Juan José Gorgojo Martínez

Head of Department of Endocrinology and Nutrition, University Hospital Fundación, Alcorcon, Madrid, Spain
Image
Dr. Patrick Holmes' image

Dr. Patrick Holmes

General Practitioner, St. George's Medical Practice, Darlington, UK

Publication under Spotlight

Cardiovascular and Renal Outcomes With Empagliflozin in Heart Failure

N Engl J Med.
2020;383(15):1413-1424.

Authors: Milton Packer, Stefan D Anker, Javed Butler, Gerasimos Filippatos, Stuart J Pocock, Peter Carson, James Januzzi, Subodh Verma, Hiroyuki Tsutsui, Martina Brueckmann, Waheed Jamal, Karen Kimura, Janet Schnee, Cordula Zeller, Daniel Cotton, Edimar Bocchi, Michael Böhm, Dong-Ju Choi, Vijay Chopra, Eduardo Chuquiure, Nadia Giannetti, Stefan Janssens, Jian Zhang, Jose R Gonzalez Juanatey, Sanjay Kaul, Hans-Peter Brunner-La Rocca, Bela Merkely, Stephen J Nicholls, Sergio Perrone, Ileana Pina, Piotr Ponikowski, Naveed Sattar, Michele Senni, Marie-France Seronde, Jindrich Spinar, Iain Squire, Stefano Taddei, Christoph Wanner, Faiez Zannad.

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