TY - JOUR
T1 - Efficacy of empagliflozin in heart failure with preserved versus mid-range ejection fraction
T2 - a pre-specified analysis of EMPEROR-Preserved
AU - Anker, Stefan D.
AU - Butler, Javed
AU - Usman, Muhammad Shariq
AU - Filippatos, Gerasimos
AU - Ferreira, João Pedro
AU - Bocchi, Edimar
AU - Böhm, Michael
AU - Rocca, Hans Pieter Brunner La
AU - Choi, Dong Ju
AU - Chopra, Vijay
AU - Chuquiure, Eduardo
AU - Giannetti, Nadia
AU - Gomez-Mesa, Juan Esteban
AU - Janssens, Stefan
AU - Januzzi, James L.
AU - González-Juanatey, José R.
AU - Merkely, Bela
AU - Nicholls, Stephen J.
AU - Perrone, Sergio V.
AU - Piña, Ileana L.
AU - Ponikowski, Piotr
AU - Senni, Michele
AU - Sim, David
AU - Spinar, Jindrich
AU - Squire, Iain
AU - Taddei, Stefano
AU - Tsutsui, Hiroyuki
AU - Verma, Subodh
AU - Vinereanu, Dragos
AU - Zhang, Jian
AU - Iwata, Tomoko
AU - Schnee, Janet M.
AU - Brueckmann, Martina
AU - Pocock, Stuart J.
AU - Zannad, Faiez
N1 - Funding Information:
This study was funded by Boehringer Ingelheim and Eli Lilly. M.Bö. is supported by the Deutsche Forschungsgemeinschaft (German Research Foundation; TTR 219, project number 322900939). S.V. holds a Tier 1 Canada Research Chair in Cardiovascular Surgery. Graphics assistance was provided by 7.4 Ltd and was funded by Boehringer Ingelheim. Assistance during the revision of this manuscript was provided by G. Brooke of Elevate Scientific Solutions, and was supported financially by Boehringer Ingelheim.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - The EMPEROR-Preserved trial showed that the sodium–glucose co-transporter 2 inhibitor empagliflozin significantly reduces the risk of cardiovascular death or hospitalization for heart failure (HHF) in heart failure patients with left ventricular ejection fraction (LVEF) > 40%. Here, we report the results of a pre-specified analysis that separately evaluates these patients stratified by LVEF: preserved (≥ 50%) (n = 4,005; 66.9%) or mid-range (41–49%). In patients with LVEF ≥ 50%, empagliflozin reduced the risk of cardiovascular death or HHF (the primary endpoint) by 17% versus placebo (hazard ratio (HR) 0.83; 95% confidence interval (CI): 0.71–0.98, P = 0.024). For the key secondary endpoint, the HR for total HHF was 0.83 (95%CI: 0.66–1.04, P = 0.11). For patients with an LVEF of 41–49%, the HR for empagliflozin versus placebo was 0.71 (95%CI: 0.57–0.88, P = 0.002) for the primary outcome (Pinteraction = 0.27), and 0.57 (95%CI: 0.42–0.79, P < 0.001) for total HHF (Pinteraction = 0.06). These results, together with those from the EMPEROR-Reduced trial in patients with LVEF < 40%, support the use of empagliflozin across the full spectrum of LVEF in heart failure.
AB - The EMPEROR-Preserved trial showed that the sodium–glucose co-transporter 2 inhibitor empagliflozin significantly reduces the risk of cardiovascular death or hospitalization for heart failure (HHF) in heart failure patients with left ventricular ejection fraction (LVEF) > 40%. Here, we report the results of a pre-specified analysis that separately evaluates these patients stratified by LVEF: preserved (≥ 50%) (n = 4,005; 66.9%) or mid-range (41–49%). In patients with LVEF ≥ 50%, empagliflozin reduced the risk of cardiovascular death or HHF (the primary endpoint) by 17% versus placebo (hazard ratio (HR) 0.83; 95% confidence interval (CI): 0.71–0.98, P = 0.024). For the key secondary endpoint, the HR for total HHF was 0.83 (95%CI: 0.66–1.04, P = 0.11). For patients with an LVEF of 41–49%, the HR for empagliflozin versus placebo was 0.71 (95%CI: 0.57–0.88, P = 0.002) for the primary outcome (Pinteraction = 0.27), and 0.57 (95%CI: 0.42–0.79, P < 0.001) for total HHF (Pinteraction = 0.06). These results, together with those from the EMPEROR-Reduced trial in patients with LVEF < 40%, support the use of empagliflozin across the full spectrum of LVEF in heart failure.
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U2 - 10.1038/s41591-022-02041-5
DO - 10.1038/s41591-022-02041-5
M3 - Article
C2 - 36471037
AN - SCOPUS:85143362333
SN - 1078-8956
VL - 28
SP - 2512
EP - 2520
JO - Nature Medicine
JF - Nature Medicine
IS - 12
ER -