The SGLT2 inhibitor empagliflozin in patients hospitalized for
acute heart failure: a multinational randomized trial

J 2022

The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial

VOORS, Adriaan A, Christiane E ANGERMANN, John R TEERLINK, Sean P COLLINS, Mikhai KOSIBOROD et. al.

Basic information

Original name

The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial

Authors

VOORS, Adriaan A (guarantor), Christiane E ANGERMANN, John R TEERLINK, Sean P COLLINS, Mikhai KOSIBOROD, Ja BIEGUS, Joao Pedr FERREIRA, Michael E NASSIFA, Mitchell A PSOTKA, Jaspe TROMP, C Jan Wille BORLEFFS, Ma CHANGSHENG, Josep COMIN-COLET, Fu MICHAEL, Stefan P JANSSENS, Robert G KISS, Robert J MENTZ, Yasush SAKATA, Henri SCHIRMER, Morte SCHOU, P Christia SCHULZ, Lenka ŠPINAROVÁ (203 Czech Republic, belonging to the institution), Maurizi VOLTERRANI, Jerzy K WRANICZ, Uw ZEYMER, Shelle ZIEROTH, Martin BRUECKMANN, Jonathan P BLATCHFORD, Afshi SALSALI and Piotr PONIKOWSKI

Edition

NATURE MEDICINE, UNITED STATES, NATURE PORTFOLIO, 2022, 1078-8956

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Germany

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 82.900

RIV identification code

RIV/00216224:14110/22:00126079

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1038/s41591-021-01659-1

UT WoS

000762162700002

Keywords in English

SGLT2 inhibitor; acute heart failure

Abstract

V originále

The sodium-glucose cotransporter 2 inhibitor empagliflozin reduces the risk of cardiovascular death or heart failure hospitalization in patients with chronic heart failure, but whether empagliflozin also improves clinical outcomes when initiated in patients who are hospitalized for acute heart failure is unknown. In this double-blind trial (EMPULSE; NCT04157751), 530 patients with a primary diagnosis of acute de novo or decompensated chronic heart failure regardless of left ventricular ejection fraction were randomly assigned to receive empagliflozin 10 mg once daily or placebo. Patients were randomized in-hospital when clinically stable (median time from hospital admission to randomization, 3 days) and were treated for up to 90 days. The primary outcome of the trial was clinical benefit, defined as a hierarchical composite of death from any cause, number of heart failure events and time to first heart failure event, or a 5 point or greater difference in change from baseline in the Kansas City Cardiomyopathy Questionnaire Total Symptom Score at 90 days, as assessed using a win ratio. More patients treated with empagliflozin had clinical benefit compared with placebo (stratified win ratio, 1.36; 95% confidence interval, 1.09-1.68; P =0.0054), meeting the primary endpoint. Clinical benefit was observed for both acute de novo and decompensated chronic heart failure and was observed regardless of ejection fraction or the presence or absence of diabetes. Empagliflozin was well tolerated; serious adverse events were reported in 32.3% and 43.6% of the empagliflozin- and placebo-treated patients, respectively. These findings indicate that initiation of empagliflozin in patients hospitalized for acute heart failure is well tolerated and results in significant clinical benefit in the 90 days after starting treatment.

Citovat

VOORS, Adriaan A, Christiane E ANGERMANN, John R TEERLINK, Sean P COLLINS, Mikhai KOSIBOROD, Ja BIEGUS, Joao Pedr FERREIRA, Michael E NASSIFA, Mitchell A PSOTKA, Jaspe TROMP, C Jan Wille BORLEFFS, Ma CHANGSHENG, Josep COMIN-COLET, Fu MICHAEL, Stefan P JANSSENS, Robert G KISS, Robert J MENTZ, Yasush SAKATA, Henri SCHIRMER, Morte SCHOU, P Christia SCHULZ, Lenka ŠPINAROVÁ, Maurizi VOLTERRANI, Jerzy K WRANICZ, Uw ZEYMER, Shelle ZIEROTH, Martin BRUECKMANN, Jonathan P BLATCHFORD, Afshi SALSALI and Piotr PONIKOWSKI. The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial. NATURE MEDICINE. UNITED STATES: NATURE PORTFOLIO, 2022, vol. 28, No 3, p. "568"-"+", 13 pp. ISSN 1078-8956. Available from: https://dx.doi.org/10.1038/s41591-021-01659-1.

@article{1861840,
   author = {Voors, Adriaan A and Angermann, Christiane E and Teerlink, John R and Collins, Sean P and Kosiborod, Mikhai and Biegus, Ja and Ferreira, Joao Pedr and Nassifa, Michael E and Psotka, Mitchell A and Tromp, Jaspe and Borleffs, C Jan Wille and Changsheng, Ma and CominandColet, Josep and Michael, Fu and Janssens, Stefan P and Kiss, Robert G and Mentz, Robert J and Sakata, Yasush and Schirmer, Henri and Schou, Morte and Schulz, P Christia and Špinarová, Lenka and Volterrani, Maurizi and Wranicz, Jerzy K and Zeymer, Uw and Zieroth, Shelle and Brueckmann, Martin and Blatchford, Jonathan P and Salsali, Afshi and Ponikowski, Piotr},
   article_location = {UNITED STATES},
   article_number = {3},
   doi = {http://dx.doi.org/10.1038/s41591-021-01659-1},
   keywords = {SGLT2 inhibitor; acute heart failure},
   language = {eng},
   issn = {1078-8956},
   journal = {NATURE MEDICINE},
   title = {The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial},
   url = {https://www.nature.com/articles/s41591-021-01659-1},
   volume = {28},
   year = {2022}
}

TY  - JOUR
ID  - 1861840
AU  - Voors, Adriaan A - Angermann, Christiane E - Teerlink, John R - Collins, Sean P - Kosiborod, Mikhai - Biegus, Ja - Ferreira, Joao Pedr - Nassifa, Michael E - Psotka, Mitchell A - Tromp, Jaspe - Borleffs, C Jan Wille - Changsheng, Ma - Comin-Colet, Josep - Michael, Fu - Janssens, Stefan P - Kiss, Robert G - Mentz, Robert J - Sakata, Yasush - Schirmer, Henri - Schou, Morte - Schulz, P Christia - Špinarová, Lenka - Volterrani, Maurizi - Wranicz, Jerzy K - Zeymer, Uw - Zieroth, Shelle - Brueckmann, Martin - Blatchford, Jonathan P - Salsali, Afshi - Ponikowski, Piotr
PY  - 2022
TI  - The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial
JF  - NATURE MEDICINE
VL  - 28
IS  - 3
SP  - "568"-"+"
EP  - "568"-"+"
PB  - NATURE PORTFOLIO
SN  - 10788956
KW  - SGLT2 inhibitor
KW  - acute heart failure
UR  - https://www.nature.com/articles/s41591-021-01659-1
N2  - The sodium-glucose cotransporter 2 inhibitor empagliflozin reduces the risk of cardiovascular death or heart failure hospitalization in patients with chronic heart failure, but whether empagliflozin also improves clinical outcomes when initiated in patients who are hospitalized for acute heart failure is unknown. In this double-blind trial (EMPULSE; NCT04157751), 530 patients with a primary diagnosis of acute de novo or decompensated chronic heart failure regardless of left ventricular ejection fraction were randomly assigned to receive empagliflozin 10 mg once daily or placebo. Patients were randomized in-hospital when clinically stable (median time from hospital admission to randomization, 3 days) and were treated for up to 90 days. The primary outcome of the trial was clinical benefit, defined as a hierarchical composite of death from any cause, number of heart failure events and time to first heart failure event, or a 5 point or greater difference in change from baseline in the Kansas City Cardiomyopathy Questionnaire Total Symptom Score at 90 days, as assessed using a win ratio. More patients treated with empagliflozin had clinical benefit compared with placebo (stratified win ratio, 1.36; 95% confidence interval, 1.09-1.68; P =0.0054), meeting the primary endpoint. Clinical benefit was observed for both acute de novo and decompensated chronic heart failure and was observed regardless of ejection fraction or the presence or absence of diabetes. Empagliflozin was well tolerated; serious adverse events were reported in 32.3% and 43.6% of the empagliflozin- and placebo-treated patients, respectively. These findings indicate that initiation of empagliflozin in patients hospitalized for acute heart failure is well tolerated and results in significant clinical benefit in the 90 days after starting treatment.
ER  -

VOORS, Adriaan A, Christiane E ANGERMANN, John R TEERLINK, Sean P COLLINS, Mikhai KOSIBOROD, Ja BIEGUS, Joao Pedr FERREIRA, Michael E NASSIFA, Mitchell A PSOTKA, Jaspe TROMP, C Jan Wille BORLEFFS, Ma CHANGSHENG, Josep COMIN-COLET, Fu MICHAEL, Stefan P JANSSENS, Robert G KISS, Robert J MENTZ, Yasush SAKATA, Henri SCHIRMER, Morte SCHOU, P Christia SCHULZ, Lenka ŠPINAROVÁ, Maurizi VOLTERRANI, Jerzy K WRANICZ, Uw ZEYMER, Shelle ZIEROTH, Martin BRUECKMANN, Jonathan P BLATCHFORD, Afshi SALSALI and Piotr PONIKOWSKI. The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial. \textit{NATURE MEDICINE}. UNITED STATES: NATURE PORTFOLIO, 2022, vol.~28, No~3, p.~''568''-''+'', 13 pp. ISSN~1078-8956. Available from: https://dx.doi.org/10.1038/s41591-021-01659-1.

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