In HFrEF, adding empagliflozin to medical therapy reduced a composite outcome, regardless of CKD status

Area of Science:

• Cardiology
• Nephrology
• Pharmacology

Background:

• Heart failure (HF) is a complex condition with high morbidity and mortality.
• Kidney function significantly influences HF prognosis and treatment strategies.
• Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as a promising therapeutic class for HF.

Purpose of the Study:

• To evaluate the efficacy of empagliflozin in patients with heart failure with reduced ejection fraction (HFrEF) across the full spectrum of kidney function.
• To assess the impact of empagliflozin on cardiovascular and renal outcomes in relation to baseline estimated glomerular filtration rate (eGFR).

Main Methods:

• Analysis of the EMPEROR-Reduced trial data.
• Inclusion of patients with HFrEF and varying degrees of kidney function (eGFR ≥ 20 mL/min/1.73 m²).
• Comparison of empagliflozin versus placebo, assessing composite primary endpoint of cardiovascular death or HF hospitalization, and key secondary renal endpoints.

Main Results:

• Empagliflozin significantly reduced the risk of the primary composite endpoint irrespective of kidney function.
• Consistent benefits were observed for both cardiac and kidney outcomes across all evaluated eGFR strata.
• No significant increase in adverse events was noted in patients with impaired kidney function.

Conclusions:

• Empagliflozin provides substantial cardiovascular and renal protection in patients with HFrEF, even in those with severely impaired kidney function.
• The findings support the use of empagliflozin as a foundational therapy for HFrEF, independent of renal status.
• Empagliflozin represents a valuable therapeutic option for managing HFrEF across a wide range of kidney function.