Publications
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Efficacy of Empagliflozin in Heart Failure with Preserved versus Mid-range Ejection Fraction: a Pre-specified Analysis of EMPEROR-Preserved
Nat Med. 2022;28:2512–2520 DOI: 10.1038/s41591-022-02041-5
Results from EMPEROR-Preserved demonstrated that empagliflozin improved CV death and HF hospitalisation – the primary outcome – in patients with HF and LVEF >40%. This pre-specified analysis of EMPEROR-Preserved aimed to evaluate the effect of empagliflozin in patients with HFpEF (LVEF ≥50%) compared with patients who had HFmrEF (LVEF 41–49%).
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Empagliflozin, Irrespective of Blood Pressure, Improves Outcomes in Heart Failure with Preserved Ejection Fraction: the EMPEROR-Preserved Trial
Eur Heart J. 2022; online ahead of print DOI: 10.1093/eurheartj/ehac693
Results from EMPEROR-Preserved demonstrated that empagliflozin improved CV and renal outcomes in patients with HFpEF, but its efficacy and safety with baseline SBP is not well established.
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Empagliflozin in Black Versus White Patients with Heart Failure: Analysis of EMPEROR-Pooled
Circulation. 2022; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.062644
While analyses from DAPA-HF and EMPEROR-Reduced demonstrated a consistent benefit of SGLT2i in Black patients, data were limited to HFrEF and included a small number of Black patients. In the current analysis, the efficacy and safety of empagliflozin according to Black vs White race in the Americas was assessed across the spectrum of EF in EMPEROR-Pooled, a combined dataset from both EMPEROR trials.
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Effects of Empagliflozin on Cardiovascular and Renal Outcomes in Heart Failure with Reduced Ejection Fraction According to Age: a Secondary Analysis of EMPEROR-Reduced
Eur J Heart Fail. 2022; online ahead of print DOI: 10.1002/ejhf.2707
Results from EMPEROR-Reduced demonstrated that empagliflozin improved CV and renal outcomes in patients with HFrEF, but its efficacy and safety across patient's age is not well established.
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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.