Empagliflozin may be beneficial in acute HF

Adults treated with empagliflozin (Jardiance—Boehringer Ingelheim, Lilly) during hospitalization for an acute heart failure (HF) event had reduced all-cause mortality, fewer HF events, and improvement in HF–related symptoms compared those given a placebo, according to results of the EMPULSE trial presented at 2021 American Heart Association (AHA) Scientific Sessions. These data add broader information supporting use sodium-glucose cotransporter 2 (SGLT-2) inhibitors improve CV events HF, specifically when care setting. “Short-term clinical outcomes patients hospitalized are poor,” said lead study author Adriaan A. Voors, MD, PhD, professor cardiology University Medical Center Groningen Netherlands. “EMPULSE shows adults were 36% more likely experience benefit over 90 days if initiated on [a] placebo following stabilization prior discharge.” Although cardiovascular benefits select SGLT-2 without type diabetes—including improved chronic HF—are well-established, physicians have been reluctant this class drugs setting due potential safety concerns. This is unfortunate because even higher risk death hospital readmission early months post-discharge. The support empagliflozin’s effects improving but also safe agent Patients no ketoacidosis or hypotension only slight drop renal function, which disappeared after approximately 15 days. Several limitations need be considered, however. First, “stable” before enrollment. Second, was added onto standard management list concurrent medications not yet published would helpful assess. Third, relatively small other major outcome trials, so additional confirmatory analyses may needed. Finally, cost always consideration adding new treatment patient’s regimen, especially they already receiving numerous manage their condition. enrolled 530 primary diagnosis defined as de novo decompensated regardless left ventricular ejection fraction diabetes status. mean age 68 years randomized receive 10 mg daily Treatment once stabilized, averaged 3 admission. composite number deaths, failure–related time first event, score least 5 points Kansas City Cardiomyopathy Questionnaire (KCCQ). assigned group. All-cause mortality 4.2% group 8.3% group, 10.6% 14.7% Fewer serious occurred active (32.3% vs. 43.6%). Additionally, who received 4.5-point increase KCCQ total symptom (mean change from baseline 36.9 31.6). Empagliflozin well-tolerated study, adverse