Portal de investigação
Vascular Disease Burden, Outcomes and Benefits with Empagliflozin in Heart Failure: Insights From the EMPEROR-Reduced Trial
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Khan, MS
- Anker, SD
- Filippatos, G
- Pocock, SJ
- Januzzi, JL
- Chopra, VK
- Piña, IL
- Böhm, M
- Ponikowski, P
- Verma, S
- Brueckmann, M
- Vedin, O
- Peil, B
- Zannad, F
- Packer, M
- Butler, J
Unidades de investigação
Abstract
Background: The presence of ischemic heart disease impacts prognosis in patients affected by heart failure and reduced ejection fraction (HFrEF). It is not well known how the extent of vascular disease impacts prognoses and responses to therapy in this setting. Methods: In this post hoc analysis of the EMPEROR-Reduced trial, outcomes and the effects of empagliflozin, were assessed in study participants according to the extent (none vs mono1 vs poly [>= 2] vascular bed) of vascular disease. Vascular disease was defined as investigator-reported coronary artery disease (CAD), peripheral artery disease (PAD) and cerebrovascular disease at baseline. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Incidence rates are presented per 100 person-years (py) of follow-up.Results: Of the 3730 study participants enrolled, 1324 (35.5%) had no vascular disease, 1879 (50.4%) had monovascular disease, and 527 (14.1%) had polyvascular disease. Participants with polyvascular disease tended to be older and male and to have had histories of hypertension, diabetes and smoking. In the placebo arm, a significantly higher risk for cardiovascular death existed in those with polyvascular disease (HR 1.57, 95% CI1.02, 2.44, compared to those with no vascular disease). In adjusted analysis, the benefit of empagliflozin in cardiovascular death or hospitalization due to HF, HF hospitalization, cardiovascular death, renal composite endpoint, estimated glomerular filtration slope changes, and health status scores were seen across the 3 groups (interaction P > 0.05 for all) but were attenuated in those with polyvascular disease. Adverse events were higher in those with polyvascular disease, but no major differences were noted between empagliflozin or placebo assignment in the 3 groups.Conclusion: In patients with HFrEF, the extent of vascular disease is associated with the risk for adverse cardiovascular outcomes. Empagliflozin offers cardiovascular and renal benefits in HFrEF across the extent of vascular disease, but this benefit is attenuated in those with polyvascular disease. (J Cardiac Fail 2023;29:1345-1354)
Dados da publicação
- ISSN/ISSNe:
- 1071-9164, 1532-8414
- Tipo:
- Article
- Páginas:
- 1345-1354
- Link para outro recurso:
- www.scopus.com
Journal of Cardiac Failure Churchill Livingstone
Citações Recebidas na Scopus: 1
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- Não há documentos
Filiações
Keywords
- angiotensin receptor antagonist; beta adrenergic receptor blocking agent; dipeptidyl carboxypeptidase inhibitor; empagliflozin; enkephalinase inhibitor; loop diuretic agent; mineralocorticoid receptor; placebo; acute heart infarction; adult; age distribution; aged; Article; cardiovascular mortality; cerebrovascular accident; cerebrovascular disease; clinical outcome; controlled study; coronary artery disease; diabetes mellitus; disease burden; double blind procedure; estimated glomerular filtration rate; female; follow up; health status; heart failure with reduced ejection fraction; hospitalization; human; hypertension; incidence; kidney function; major clinical study; male; medical history; middle aged; mortality risk; peripheral arterial disease; post hoc analysis; prognosis; randomized controlled trial; sex difference; smoking; unspecified side effect; vascular disease
Proyectos asociados
Dapagliflozin, Spironolactone or Both for HFpEF (SOGALDI-PEF) - NCT05676684
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (SOGALDI-PEF) . AstraZeneca . 2022
Initiation of ARNi and SGLT2i in Patients With HFrEF: Randomized Open-label Trial (INITIATE-HFrEF) -NCT05989503
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (INITIATE-HFrEF) . Novartis . 2023
Citar a publicação
Khan MS,Anker SD,Filippatos G,Ferreira JP,Pocock SJ,Januzzi JL,Chopra VK,Piña IL,Böhm M,Ponikowski P,Verma S,Brueckmann M,Vedin O,Peil B,Zannad F,Packer M,Butler J. Vascular Disease Burden, Outcomes and Benefits with Empagliflozin in Heart Failure: Insights From the EMPEROR-Reduced Trial. J. Card. Fail. 2023. 29. (10):p. 1345-1354. IF:6,000. (1).
