Portal de investigação
Body mass index and cardiorenal outcomes in the EMPEROR-Preserved trial: Principal findings and meta-analysis with the DELIVER trial
Data de publicação:
Autores da FMUP
Participantes de fora da FMUP
- Sattar N.
- Butler J.
- Lee M.M.Y.
- Harrington J.
- Sharma A.
- Zannad F.
- Filippatos G.
- Verma S.
- Januzzi J.L.
- Pocock S.J.
- Pfarr E.
- Ofstad A.P.
- Brueckmann M.
- Packer M.
- Anker S.D.
Unidades de investigação
Abstract
Aims: Both low and high body mass index (BMI) are associated with poor heart failure outcomes. Whether BMI modifies benefits of sodium–glucose cotransporter 2 inhibitors (SGLT2i) in heart failure with preserved ejection fraction (HFpEF) requires further investigation. Methods and results: Using EMPEROR-Preserved data, the effects of empagliflozin versus placebo on the risks for the primary outcome (hospitalization for heart failure [HHF] or cardiovascular [CV] death), change in estimated glomerular filtration rate (eGFR) slopes, change in Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS), and secondary outcomes across baseline BMI categories (<25 kg/m2, 25 to <30 kg/m2, 30 to <35 kg/m2, 35 to <40 kg/m2 and =40 kg/m2) were examined, and a meta-analysis conducted with DELIVER. Forty-five percent had a BMI of =30 kg/m2. For the primary outcome, there was a consistent treatment effect of empagliflozin versus placebo across the BMI categories with no formal interaction (p trend = 0.19) by BMI categories. There was also no difference in the effects on secondary outcomes including total HHF (p trend = 0.19), CV death (p trend = 0.20), or eGFR slope with slower declines with empagliflozin regardless of BMI (range 1.12–1.71 ml/min/1.73 m2 relative to placebo, p trend = 0.85 for interaction), though there was no overall impact on the composite renal endpoint. The difference in weight change between empagliflozin and placebo was -0.59, -1.48, -1.54, -0.87, and - 2.67 kg in the lowest to highest BMI categories (p trend = 0.016 for interaction). A meta-analysis of data from EMPEROR-Preserved and DELIVER showed a consistent effect of SGLT2i versus placebo across BMI categories for the outcome of HHF or CV death. There was a trend toward greater absolute KCCQ-CSS benefit at 32 weeks with empagliflozin at higher BMIs (p = 0.08). Conclusions: Empagliflozin treatment resulted in broadly consistent cardiac effects across the range of BMI in patients with HFpEF. SGLT2i treatment yields benefit in patients with HFpEF regardless of baseline BMI. © 2024 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
Dados da publicação
- ISSN/ISSNe:
- 1388-9842, 1879-0844
- Tipo:
- Article
- Páginas:
- 900-909
- DOI:
- 10.1002/ejhf.3221
- Link para outro recurso:
- www.scopus.com
European Journal of Heart Failure Wiley-Blackwell
Citações Recebidas na Scopus: 4
Documentos
- Não há documentos
Filiações
Keywords
- Aged; Benzhydryl Compounds; Body Mass Index; Female; Glomerular Filtration Rate; Glucosides; Heart Failure; Hospitalization; Humans; Male; Middle Aged; Sodium-Glucose Transporter 2 Inhibitors; Stroke Volume; Treatment Outcome; amino terminal pro brain natriuretic peptide; angiotensin receptor antagonist; beta adrenergic receptor blocking agent; empagliflozin; mineralocorticoid antagonist; natriuretic factor; placebo; benzhydryl derivative; empagliflozin; glucoside; sodium glucose cotransporter 2 inhibitor; aged; Article; atrial fibrillation; body mass; cardiorenal outcome; dialysis; double blind procedure; estimated glomerular filtration rate; female; heart failure with reduced ejection fraction; hospitalization; human; Kansas City Cardiomyopathy Questionnaire clinical summary score; kidney transplantation; major clinical study; male; meta analysis; New York Heart Association class; outcome assessment; phase 3 clinical trial; scoring system; controlled study; drug therapy; glomerulus f
Financiamento
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
Sattar N,Butler J,Lee MMY,Harrington J,Sharma A,Zannad F,Filippatos G,Verma S,Januzzi JL,Ferreira JP,Pocock SJ,Pfarr E,Ofstad AP,Brueckmann M,Packer M,Anker SD. Body mass index and cardiorenal outcomes in the EMPEROR-Preserved trial: Principal findings and meta-analysis with the DELIVER trial. Eur. J. Heart Fail. 2024. 26. (4):p. 900-909. IF:18,200. (1).
