Empagliflozin and Serum Potassium in Heart Failure: An Analysis From Emperor-Pooled
Eur Heart J 2022; online ahead of print DOI: 10.1093/eurheartj/ehac306
Some studies suggest sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce hyperkalaemia. EMPEROR-Pooled evaluated the effect of empagliflozin on the occurrence of hyper- and hypokalaemia in HF in 9,583 patients from the EMPEROR-Reduced and EMPEROR-Preserved Phase 3 trials. Serum potassium was measured at randomisation and each subsequent study visit. The main outcome was a composite of investigator-reported hyperkalaemia or initiation of potassium binders.
Compared with placebo, empagliflozin reduced the occurrence of the main composite outcome, although the use of potassium binders was not significantly reduced. The effect was consistent across both trials and most subgroups. These findings in a large group of HF patients across a range of ejection fractions are clinically important and expand the potential benefits of empagliflozin in HF.