medwireNews: A prespecified analysis of EMPEROR-Preserved indicates benefits of empagliflozin for people with heart failure (HF) and mildly reduced or preserved left ventricular ejection fraction (LVEF).
The trial included 4005 people with HF and preserved LVEF (≥50%; HFpEF) and 1983 in whom it was mildly reduced (41–49%; HFmrEF).
Stefan Anker (Charité Universitätsmedizin Berlin, Germany) and co-researchers report that the two groups had “some notably different clinical characteristics” and observe that HFmrEF has been “poorly studied” in previous trials, because of the cutoffs used to define reduced and preserved ejection fraction.
In this analysis, published in Nature Medicine, the team found that both groups gained significant benefit from taking empagliflozin versus placebo, although the effect was “less pronounced” in people with fully preserved LVEF.
Specifically, this subgroup had a significant 17% reduction in risk for the primary outcome of cardiovascular death or HF hospitalization, whereas people with HFmrEF had a significant 29% risk reduction, although the difference between the two was not statistically significant. The corresponding numbers needed to treat to prevent one first HF hospitalization over 2.15 years were 44 and 20.
Given the substantial benefit of empagliflozin observed in people with HFmrEF, the researchers argue that its distinction from HF with reduced LVEF “may not be relevant from a clinical perspective.”
And added to the EMPEROR-Reduced findings, they say their results “support the use of empagliflozin across the full spectrum of LVEF in heart failure.”
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