Effect of empagliflozin in patients with heart failure across the spectrum of left ventricular ejection fraction
Key result
Empagliflozin cuts HF hospitalization ~30% across EF <65% but benefit attenuates at EF ≥65%.
Why the study?
No therapy had been shown to reduce the risk of heart failure hospitalization across the entire range of ejection fractions seen in clinical practice.
Does empagliflozin reduce cardiovascular mortality or heart failure hospitalization in patients with heart failure across the spectrum of left ventricular ejection fraction?
Population
9718 patients with heart failure across the spectrum of ejection fraction
Comparison
Empagliflozin vs placebo
Design
Pooled analysis of the EMPEROR-Reduced and EMPEROR-Preserved trials
Authors
Discussion
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Implication
Supports empagliflozin for heart failure with ejection fraction <65%; extends randomized evidence across most of the ejection fraction spectrum.
Key Points
- This research aims to evaluate how ejection fraction influences the impact of empagliflozin on heart failure outcomes.
- Pooled analysis of EMPEROR-Reduced and EMPEROR-Preserved trials
- Group patients by ejection fraction levels
- Assess multiple heart failure outcomes including hospitalizations and mortality
- Empagliflozin reduced cardiovascular death and heart failure hospitalizations across ejection fractions
- Risk reduction for heart failure hospitalization was approximately 30% in groups with ejection fractions <65%
- Attenuated effect in patients with ejection fraction ≥65% with hazard ratio of 1.05
Structured PICO
Does empagliflozin reduce cardiovascular mortality or heart failure hospitalization in patients with heart failure across the spectrum of left ventricular ejection fraction?
P
Population
9,718 patients with heart failure across the spectrum of left ventricular ejection fraction (pooled from EMPEROR-Reduced and EMPEROR-Preserved trials)
I
Intervention
Empagliflozin
C
Comparator
Placebo
O
Outcome
Time to first hospitalization for heart failure or cardiovascular mortalitycomposite
Empagliflozin provides consistent clinical benefits in reducing heart failure hospitalizations across a broad range of ejection fractions (<25% to <65%), but the effect is attenuated at LVEF ≥65%.
Cite This Study
Butler et al. (2021) studied this question. Empagliflozin reduced the risk of heart failure hospitalization by approximately 30% across ejection fractions <65%, but showed an attenuated effect in ejection fraction ≥65%.