Publications
Stay up to date with our literature reviews which are curated by experts to feature the most important publications released each month. Explore our publications for access to concise summary slides for your own use.
Empagliflozin in Patients with Chronic Kidney Disease
N Engl J Med. 2022; online ahead of print
Among a wide range of at-risk patients with CKD, empagliflozin reduced progression of kidney disease or death from CV causes compared with placebo in the EMPA-KIDNEY trial.
Previous large trials involving patients with diabetic kidney disease and albuminuria have shown that SGLT2i reduce the risk of progression to kidney failure; however, most patients with CKD have low levels of albuminuria (UACR <300 mg/g) and do not have diabetes.
Empagliflozin and Left Ventricular Remodeling in People Without Diabetes: Primary Results of the EMPA-HEART 2 CardioLink-7 Randomized Clinical Trial
Circulation. 2022; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.062769
Among patients with neither diabetes nor significant HF but with risk factors for adverse cardiac remodelling, empagliflozin did not result in a meaningful reduction in change in left ventricular mass indexed (LVMi) to baseline body surface area (BSA) after 6 months as measured by cardiac magnetic resonance imaging.
SGLT2i have demonstrated reverse cardiac remodelling in patients with diabetes or HF, but their effects earlier in the natural history of HF are less well studied.
Renal effects of empagliflozin in patients hospitalized for acute heart failure: from the EMPULSE trial
Eur J Heart Fail. 2022; online ahead of print DOI: 10.1002/ejhf.2681
In a post-hoc analysis of EMPULSE in patients with acute heart failure (AHF), the clinical benefit of empagliflozin was consistent regardless of baseline renal function.
In the primary analysis of EMPULSE trial, initiation of empagliflozin in patients hospitalised for acute HF resulted in clinical benefit (a composite of all-cause death, number of HF events and time to first HF event and quality of life) at 90 days. However, the effects of empagliflozin and other sodium-glucose cotransporter-2 inhibitors (SGLT2i) on renal function during a hospital admission for acute HF remain largely unknown.
Mechanisms underlying the blood pressure-lowering effects of empagliflozin, losartan and their combination in people with type 2 diabetes: A secondary analysis of a randomized crossover trial
Diabetes Obes Metab. 2022; online ahead of print DOI: 10.1111/dom.14864
This prespecified analysis of the RECOLAR study investigated the effects of the sodium-glucose co-transporter-2 inhibitor (SGLT2i), empagliflozin, the angiotensin receptor blocker (ARB), losartan, and their combination on blood-pressure lowering, while studying the mechanisms potentially involved.
Canagliflozin and atrial fibrillation in type 2 diabetes mellitus: A secondary analysis from the CANVAS Program and CREDENCE trial and meta-analysis
Diabetes Obes Metab. 2022;24:1927–1938 DOI: 10.1111/dom.14772
A pooled analysis from the CANVAS Program and CREDENCE trial found that canagliflozin did not have a significant effect on the incidence of atrial fibrillation/atrial flutter (AF/AFL) in patients with type 2 diabetes and high risk of cardiovascular disease or chronic kidney disease.
Association of Empagliflozin Treatment With Albuminuria Levels in Patients With Heart Failure: A Secondary Analysis of EMPEROR-Pooled
JAMA Cardiol. 2022; online ahead of print DOI: 10.1001/jamacardio.2022.2924
In a post-hoc analysis of EMPEROR-Pooled, empagliflozin was associated with a reduction in the primary outcome irrespective of albuminuria levels at baseline compared with placebo, and there was reduced progression to macroalbuminuria and reversion of macroalbuminuria.
Dapagliflozin in Patients Recently Hospitalized With Heart Failure and Mildly Reduced or Preserved Ejection Fraction
J Am Coll Cardiol. 2022; online ahead of print DOI: 10.1016/j.jacc.2022.07.021
This prespecified analysis of the DELIVER trial found that dapagliflozin had beneficial effects on cardiovascular (CV) outcomes in patients with heart failure (HF) with mildly reduced or preserved left ventricular ejection fraction (LVEF) who were enrolled during or following hospitalisation.
Dapagliflozin across the range of ejection fraction in patients with heart failure: a patient-level, pooled meta-analysis of DAPA-HF and DELIVER
Nat Med. 2022; online ahead of print DOI: 10.1038/s41591-022-01971-4
In a prospective, patient-level pooled meta-analysis of the DAPA-HF and DELIVER trials, dapagliflozin was found to improve clinical outcomes across the range of LVEF.
Effect of Empagliflozin on Kidney Biochemical and Imaging Outcomes in Patients With Type 2 Diabetes, or Prediabetes, and Heart Failure with Reduced Ejection Fraction (SUGAR-DM-HF)
Circulation 2022;146:364-7 DOI: 10.1161/CIRCULATIONAHA.122.059851
This study found that a reduction in kidney perfusion and congestion may be mechanisms by which sodium-glucose cotransporter-2 inhibitors (SGLT2i) affect kidney function in people with heart failure with reduced ejection fraction (HFrEF). The authors believe this is the first kidney MRI trial using SGLT2i in this patient group.
Uric Acid and Sodium-Glucose Cotransporter-2 Inhibition With Empagliflozin in Heart Failure With Reduced Ejection Fraction: The EMPEROR-Reduced Trial
Eur Heart J 2022; online ahead of print doi.org/10.1093/eurheartj/ehac320
Hyperuricaemia is common in heart failure (HF) and is an independent predictor of advanced disease severity and increased mortality. This analysis from EMPEROR-Reduced showed that empagliflozin induced a rapid and sustained reduction of both serum uric acid (SUA) and of clinical events related to hyperuricaemia.