Portal de investigação
Early changes in estimated glomerular filtration rate post-initiation of empagliflozin in EMPEROR-Preserved
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Rastogi, T
- Butler, J
- Kraus, BJ
- Mattheus, M
- Brueckmann, M
- Filippatos, G
- Wanner, C
- Pocock, SJ
- Packer, M
- Anker, SD
- Zannad, F
Unidades de investigação
Abstract
Aims Renal function (estimated glomerular filtration rate [eGFR]) changes early after the introduction of empagliflozin have not been described in heart failure with preserved ejection fraction (HFpEF). The aim of this study was to describe early eGFR changes, assess its determinants and its clinical impact on cardiovascular and renal outcomes in patients with HFpEF enrolled in EMPEROR-Preserved.Methods and results Estimated glomerular filtration rate changes (absolute and relative) from randomization to week 4 were calculated and landmark analyses performed. Initial eGFR change was available in 5836 patients (97.5% of the population). Empagliflozin induced a mean eGFR change of -3.2 ml/min/1.73 m(2) versus placebo from baseline to week 4. After week 4, in the empagliflozin group, the risk of the primary outcome (composite of heart failure hospitalization or cardiovascular death), cardiovascular, all-cause mortality and sustained >= 50% eGFR decrease or end-stage renal disease (ESRD) did not differ by eGFR change levels. In contrast, in the placebo group, patients included in the tertile with most profound eGFR decrease (i.e. >= 5.1% from baseline) had a higher risk of the primary outcome (hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.17-1.82), cardiovascular mortality (HR 1.38, 95% CI 1.01-1.89) and sustained >= 50% eGFR decrease or ESRD (HR 2.20, 95% CI 1.20-4.04) versus tertile with eGFR increase.Conclusion An initial relatively small eGFR decrease may be expected after empagliflozin initiation. Such small eGFR decrease was not associated with adverse cardiovascular outcomes with empagliflozin. In contrast, eGFR decrease was associated with poor cardiovascular outcomes with placebo.
Dados da publicação
- ISSN/ISSNe:
- 1388-9842, 1879-0844
- Tipo:
- Article
- Páginas:
- 885-896
- DOI:
- 10.1002/ejhf.3136
- Link para outro recurso:
- www.scopus.com
European Journal of Heart Failure Wiley-Blackwell
Citações Recebidas na Web of Science: 3
Citações Recebidas na Scopus: 3
Documentos
- Não há documentos
Filiações
Keywords
- Estimated glomerular filtration rate changes; Heart failure with preserved ejection fraction; Empagliflozin; Cardiovascular and renal outcomes
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
Rastogi T,Ferreira JP,Butler J,Kraus BJ,Mattheus M,Brueckmann M,Filippatos G,Wanner C,Pocock SJ,Packer M,Anker SD,Zannad F. Early changes in estimated glomerular filtration rate post-initiation of empagliflozin in EMPEROR-Preserved. Eur. J. Heart Fail. 2024. 26. (4):p. 885-896. IF:18,200. (1).
