TY - JOUR
TI - Empagliflozin Improves Cardiovascular and Renal Outcomes in Heart
Failure Irrespective of Systolic Blood Pressure
AU - Boehm, Michael
AU - Anker, Stefan D.
AU - Butler, Javed
AU - Filippatos,
AU - Gerasimos
AU - Ferreira, Joao Pedro
AU - Pocock, Stuart J.
AU - Mahfoud,
AU - Felix
AU - Brueckmann, Martina
AU - Jamal, Waheed
AU - Ofstad, Anne
AU - Pernille
AU - Schueler, Elke
AU - Ponikowski, Piotr
AU - Wanner, Christoph
AU - and Zannad, Faiez
AU - Packer, Milton
AU - EMPEROR Reduced Trial Comm
AU - Invest
JO - Journal of the American College of Cardiology
PY - 2021
VL - 78
TODO - 13
SP - 1337-1348
PB - EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
SN - 0735-1097, 1558-3597
TODO - 10.1016/j.jacc.2021.07.049
TODO - empagliflozin; heart failure; kidney outcomes; systolic blood pressure;
cardiovascular outcomes
TODO - BACKGROUND Empagliflozin reduces the risk of cardiovascular death or
heart failure (HF) hospitalization in patients with reduced ejection
fraction. Its interplay with systolic blood pressure (SBP) is not known.
OBJECTIVES The goal of this study was to evaluate the interplay of SBP
and the effects of empagliflozin in EMPEROR Reduced (Empagliflozin
Outcome Trial in Patients With Chronic Heart Failure With Reduced
Ejection Fraction). METHODS Study patients (N = 3,730) were randomly
assigned to groups according to SBP at baseline (<110 mm Hg, n = 928;
110-130 mm Hg, n =1,755; >130 mm Hg, n = 1,047). This study explored the
influence of SBP on the effects of empagliflozin on cardiovascular death
or HF hospitalization (primary outcome), as well as on total HF
hospitalizations, rate of decline in estimated glomerular filtration
rate, renal outcomes, and empagliflozin’s effects and significance on
SBP. RESULTS Over a median of 16 months considering only patients
receiving placebo, baseline SBP and the risk of cardiovascular death or
hospitalization for HF (P trend = 0.0015) were inversely related.
Corrected for placebo, a slight early increase was observed in SBP at
<110 mm Hg, no change at 110-130 mm Hg, and a slight reduction at >130
mm Hg. These between-group differences were of borderline significance
(P for interaction trend = 0.05-0.10) after 4 and 12 weeks but were not
significant later. SBP at baseline did not influence the effect of
empagliflozin to reduce the risk of HF events or renal endpoints. When
treated with empagliflozin, patients with SBP <110 mm Hg did not have an
increased rate of symptomatic hypotension. CONCLUSIONS Empagliflozin was
effective and safe, with no meaningful interaction between SBP and the
effects of empagliflozin in the EMPEROR-Reduced trial. (Empagliflozin
Outcome Trial in Patients With Chronic Heart Failure With Reduced
Ejection Fraction [EMPEROR-Reduced]; NCT03057977) (J Am Coll Cardiol
2021;78:1337-1348) (c) 2021 The Authors. Published by Elsevier on behalf
of the American College of Cardiology Foundation. This is an open access
article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
ER -