Portal de investigação
Uric Acid and SGLT2 Inhibition With Empagliflozin in Heart Failure With Preserved Ejection Fraction: The EMPEROR-Preserved Trial
Data de publicação:
Autores da FMUP
Participantes de fora da FMUP
- Doehner W.
- Anker S.D.
- Butler J.
- Zannad F.
- Filippatos G.
- Coats A.J.S.
- Henrichmoeller I.
- Brueckmann M.
- Schueler E.
- Pocock S.J.
- Januzzi J.L.
- Packer M.
Unidades de investigação
Abstract
Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve outcome in patients with heart failure (HF) and reduce serum uric acid (SUA). The relevance of this metabolic effect in patients with heart failure with preserved ejection fraction (HFpEF) is unclear. Objectives: The authors investigated the effect of empagliflozin on SUA levels in relation to the therapeutic efficacy in patients with HFpEF. Methods: This post hoc analysis of the EMPEROR-Preserved (EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction; NCT03057951) trial assessed the clinical effect of SUA reduction in relation to the outcome endpoints of the trial (composite primary outcome of cardiovascular mortality or hospitalization for HF, its individual components, and all-cause mortality in patients with HFpEF). Results: Hyperuricemia (SUA >5.7 mg/dL for women, >7.0 mg/dL for men) was prevalent in 49% of patients. Elevated SUA (highest tertile SUA 8.8 ± 1.4 g/dL) was associated with advanced HF severity and with higher risk of adverse outcome (primary endpoint HR: 1.23 [95% CI: 0.98-1.53]; P = 0.07; HF hospitalization HR: 1.42 [95% CI: 1.08-1.86]; P = 0.01). SUA was reduced early (after 4 weeks vs placebo -0.99 ± 0.03 mg/dL; P < 0.0001) and throughout follow-up, with reduction in all prespecified subgroups. Empagliflozin reduced clinical events of hyperuricemia (acute gout, gouty arthritis, or initiation of antigout therapy) by 38% (HR: 0.62 [95% CI: 0.51-0.76]; P < 0.0001). The treatment benefit on the primary endpoint was not influenced by baseline SUA (HR: 0.79 [95% CI: 0.69-0.90]; P = 0.0004). The change in SUA was an independent correlate of the treatment benefit on the primary endpoint (P = 0.07). Conclusions: Hyperuricemia is a common complication in HFpEF and is related to advanced disease severity and adverse outcome. Empagliflozin induced a rapid and sustained reduction of SUA levels and of clinical events related to hyperuricemia. © 2024 The Authors
Dados da publicação
- ISSN/ISSNe:
- 2213-1787, 2213-1779
- Tipo:
- Article
- Páginas:
- 2057-2070
- Link para outro recurso:
- www.scopus.com
JACC-HEART FAILURE Elsevier BV
Citações Recebidas na Scopus: 1
Documentos
- Não há documentos
Filiações
Keywords
- Aged; Benzhydryl Compounds; Double-Blind Method; Female; Glucosides; Heart Failure; Hospitalization; Humans; Hyperuricemia; Male; Middle Aged; Sodium-Glucose Transporter 2 Inhibitors; Stroke Volume; Treatment Outcome; Uric Acid; angiotensin receptor antagonist; atrial natriuretic factor; biological marker; brain natriuretic peptide; canagliflozin; colchiceine; colchicine; dipeptidyl carboxypeptidase inhibitor; empagliflozin; galectin 3; hemoglobin A1c; metformin; metoprolol; mineralocorticoid antagonist; nonsteroid antiinflammatory agent; placebo; reactive oxygen metabolite; sodium glucose cotransporter 2; sodium glucose cotransporter 2 inhibitor; superoxide dismutase; tolvaptan; uric acid; uricosuric agent; xanthine; xanthine oxidase inhibitor; benzhydryl derivative; empagliflozin; glucoside; sodium glucose cotransporter 2 inhibitor; acute heart failure; adult; aged; albuminuria; Article; atrial fibrillation; body mass; cardiac resynchronization therapy; cardiovascular disease; cardio
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
Doehner W,Anker SD,Butler J,Zannad F,Filippatos G,Coats AJS,Ferreira JP,Henrichmoeller I,Brueckmann M,Schueler E,Pocock SJ,Januzzi JL,Packer M. Uric Acid and SGLT2 Inhibition With Empagliflozin in Heart Failure With Preserved Ejection Fraction: The EMPEROR-Preserved Trial. JACC Heart Fail. 2024. 12. (12):p. 2057-2070. IF:13,000. (1).
