Portal de investigação
Efficacy and Safety of Empagliflozin According to Background Diuretic Use in HFrEF
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Dhingra, NK
- Verma, S
- Butler, J
- Anker, SD
- Filippatos, G
- Januzzi, JL
- Lam, CSP
- Sattar, N
- Zaremba-Pechmann, L
- Böhm, M
- Nordaby, M
- Brueckmann, M
- Pocock, SJ
- Zannad, F
- Packer, M
- EMPEROR Reduced Trial Committees I
Unidades de investigação
Abstract
BACKGROUND The EMPEROR-Reduced (EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction) trial established the efficacy of empagliflozin in reducing heart failure (HF) outcomes among patients with heart failure with reduced ejection fraction (HFrEF). OBJECTIVES The authors examined the outcomes of EMPEROR-Reduced as a function of background diuretic therapy. METHODS The EMPEROR-Reduced trial was a double-blind, randomized controlled trial of placebo vs empagliflozin 10 mg among 3,730 HFrEF patients. Herein, the population was stratified into 4 groups: no diuretic and diuretic dose equivalent to furosemide <40, 40, and >40 mg daily at baseline. RESULTS A total of 3,656 patients from the EMPEROR-Reduced trial were available for analysis. Of those patients, 482 (13.2%) were receiving no diuretic therapy, and 731 (20.0%), 1,411 (38.6%), and 1,032 (28.2%) were receiving <40 mg, 40 mg, and >40 mg, respectively. The efficacy of empagliflozin on the primary outcome (time to first event of hospitalization for HF or cardiovascular [CV] death) was consistent regardless of background diuretic therapy (>40 mg: HR: 0.88 [95% CI: 0.71-1.10]; 40 mg: HR: 0.65 [95% CI: 0.51-0.82]; <40 mg: HR: 0.65 [95% CI: 0.46-0.92]); no diuretic agents: HR: 0.78 [95% CI: 0.47-1.29]; Ptrend test 1/4 0.192). Baseline diuretic doses did not influence the effect of empagliflozin on body weight, systolic blood pressure, NT-proBNP, or hematocrit at 52 weeks. The safety profile of empagliflozin vs placebo was unaffected by baseline diuretic dose; however, independently of treatment allocation, total rates of adverse events were higher among patients with higher baseline doses of diuretic agents. CONCLUSIONS Empagliflozin exhibits a consistent effect on time to CV death or HF hospitalization and an unaltered safety profile regardless of baseline diuretic therapy. (EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction [EMPEROR-Reduced]; NCT03057977) (J Am Coll Cardiol HF 2024;12:35-46) (c) 2024 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Dados da publicação
- ISSN/ISSNe:
- 2213-1787, 2213-1779
- Tipo:
- Article
- Páginas:
- 35-46
- Link para outro recurso:
- www.scopus.com
JACC-HEART FAILURE Elsevier BV
Citações Recebidas na Web of Science: 5
Citações Recebidas na Scopus: 5
Documentos
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Filiações
Keywords
- diuretic agents; empagliflozin; heart failure with reduced ejection fraction
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
Dhingra NK,Verma S,Butler J,Anker SD,Ferreira JP,Filippatos G,Januzzi JL,Lam CSP,Sattar N,Zaremba L,Böhm M,Nordaby M,Brueckmann M,Pocock SJ,Zannad F,Packer M,EMPEROR Reduced Trial Committees I. Efficacy and Safety of Empagliflozin According to Background Diuretic Use in HFrEF. JACC Heart Fail. 2024. 12. (1):p. 35-46. IF:13,000. (1).
