Effects of empagliflozin in patients with heart failure and preserved ejection fraction according to baseline diuretic use: results from the EMPEROR-Preserved trial

Abstract Background In the EMPEROR-Preserved trial, empagliflozin reduced risk of hospitalizations for heart failure (HHF) or cardiovascular (CV) death in patients with and preserved ejection fraction (HFpEF). Almost one five trial were not on baseline diuretic therapy. Purpose To evaluate efficacy safety according to treatment, as well change therapy after initiation empagliflozin. Methods Patients categorized into subgroups no furosemide-equivalent dose <40, 40 >40mg compared first HHF CV death, HHF, total eGFR slope, Kansas City Cardiomyopathy Questionnaire – Clinical Summary Scores (KCCQ-CSS) between vs. placebo. Changes two treatment groups also compared. Results Amongst 5815 data dose, 1179 (20%) diuretic, 2039 (35%) <40mg, 1700 (29%) 40mg, 897 (15%) at baseline. higher doses more likely be diabetic, had a body weight NT-proBNP, lower estimated glomerular filtration rate (eGFR) average. worse health status based NYHA class KCCQ-CSS estimates. The reduction CVD preservation eGFR, improvement consistent across all diuretics (Table 1). findings outcomes (any dose) diuretics. Treatment was associated decreased rates (HR: 0.73 [0.59,0.90; p=0.004) intensification 0.74; [0.65, 0.84]; p<0.001) diuretics, while there increased permanent discontinuation 1.46 [1.17, 1.82]; 1.22 [1.06, 1.42]; p=0.007). incidence adverse events similar arms, irrespective use Volume depletion common amongst treated (7.4 vs 5.7 per 100 patient-years placebo). Conclusion Empagliflozin improved clinical HFpEF Additionally, de-escalation chances intensification. Funding Acknowledgement Type funding sources: Private company. Main source(s): Boehringer Ingelheim & Eli Lilly Company Diabetes Alliance