Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights From EMPEROR-Reduced.
empagliflozin
glomerular filtration rate
heart failure
renal insufficiency, chronic
Journal
Circulation
ISSN: 1524-4539
Titre abrégé: Circulation
Pays: United States
ID NLM: 0147763
Informations de publication
Date de publication:
26 01 2021
26 01 2021
Historique:
pubmed:
24
10
2020
medline:
29
12
2021
entrez:
23
10
2020
Statut:
ppublish
Résumé
In EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction), empagliflozin reduced cardiovascular death or heart failure (HF) hospitalization and total HF hospitalizations, and slowed the progressive decline in kidney function in patients with HF and a reduced ejection fraction, with and without diabetes. We aim to study the effect of empagliflozin on cardiovascular and kidney outcomes across the spectrum of kidney function. In this prespecified analysis, patients were categorized by the presence or absence of chronic kidney disease (CKD) at baseline (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m Of 3730 patients who were randomized to empagliflozin or placebo, 1978 (53%) had CKD. Empagliflozin reduced the primary outcome and total HF hospitalizations in patients with and without CKD: hazard ratio (HR)=0.78 (95% CI, 0.65-0.93) and HR=0.72 (95% CI, 0.58-0.90), respectively (interaction In EMPEROR-Reduced, empagliflozin had a beneficial effect on the key efficacy outcomes and slowed the rate of kidney function decline in patients with and without CKD, and regardless of the severity of kidney impairment at baseline. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03057977.
Sections du résumé
BACKGROUND
In EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction), empagliflozin reduced cardiovascular death or heart failure (HF) hospitalization and total HF hospitalizations, and slowed the progressive decline in kidney function in patients with HF and a reduced ejection fraction, with and without diabetes. We aim to study the effect of empagliflozin on cardiovascular and kidney outcomes across the spectrum of kidney function.
METHODS
In this prespecified analysis, patients were categorized by the presence or absence of chronic kidney disease (CKD) at baseline (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m
RESULTS
Of 3730 patients who were randomized to empagliflozin or placebo, 1978 (53%) had CKD. Empagliflozin reduced the primary outcome and total HF hospitalizations in patients with and without CKD: hazard ratio (HR)=0.78 (95% CI, 0.65-0.93) and HR=0.72 (95% CI, 0.58-0.90), respectively (interaction
CONCLUSIONS
In EMPEROR-Reduced, empagliflozin had a beneficial effect on the key efficacy outcomes and slowed the rate of kidney function decline in patients with and without CKD, and regardless of the severity of kidney impairment at baseline. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03057977.
Identifiants
pubmed: 33095032
doi: 10.1161/CIRCULATIONAHA.120.051685
pmc: PMC7834910
doi:
Substances chimiques
Benzhydryl Compounds
0
Glucosides
0
Sodium-Glucose Transporter 2 Inhibitors
0
empagliflozin
HDC1R2M35U
Banques de données
ClinicalTrials.gov
['NCT03057977']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
310-321Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : ErratumIn
Type : CommentIn
Références
J Am Soc Nephrol. 2019 Sep;30(9):1735-1745
pubmed: 31292197
Lancet. 1999 Jul 31;354(9176):359-64
pubmed: 10437863
Lancet. 2019 Jan 5;393(10166):31-39
pubmed: 30424892
N Engl J Med. 2019 Jan 24;380(4):347-357
pubmed: 30415602
Circ Cardiovasc Qual Outcomes. 2013 May 1;6(3):333-42
pubmed: 23685625
N Engl J Med. 2020 Oct 8;383(15):1413-1424
pubmed: 32865377
N Engl J Med. 2001 Sep 20;345(12):851-60
pubmed: 11565517
Circulation. 2018 Jan 9;137(2):119-129
pubmed: 28904068
Lancet. 2020 Feb 29;395(10225):709-733
pubmed: 32061315
J Am Coll Cardiol. 2019 May 21;73(19):2365-2383
pubmed: 30844480
Horm Metab Res. 2016 Mar;48(3):191-5
pubmed: 26158396
N Engl J Med. 2019 Nov 21;381(21):1995-2008
pubmed: 31535829
Eur J Heart Fail. 2019 Oct;21(10):1270-1278
pubmed: 31584231
J Am Coll Cardiol. 2002 Jan 2;39(1):60-9
pubmed: 11755288
Eur Heart J. 2017 Jun 21;38(24):1883-1890
pubmed: 28329163
N Engl J Med. 2016 Jul 28;375(4):323-34
pubmed: 27299675
N Engl J Med. 2020 Oct 8;383(15):1436-1446
pubmed: 32970396
Diabetes. 2019 Feb;68(2):248-257
pubmed: 30665953
Lancet Diabetes Endocrinol. 2019 Nov;7(11):845-854
pubmed: 31495651
Circulation. 2020 Sep 29;142(13):1236-1245
pubmed: 32845715
N Engl J Med. 2006 Jan 12;354(2):131-40
pubmed: 16407508
N Engl J Med. 2019 Jun 13;380(24):2295-2306
pubmed: 30990260
Am J Kidney Dis. 2020 Jan;75(1):84-104
pubmed: 31473020
N Engl J Med. 2001 Sep 20;345(12):861-9
pubmed: 11565518
N Engl J Med. 2015 Nov 26;373(22):2117-28
pubmed: 26378978
Am J Physiol Renal Physiol. 2020 Jan 1;318(1):F67-F75
pubmed: 31682172
Circulation. 2019 Apr 23;139(17):1985-1987
pubmed: 31009585
Lancet Diabetes Endocrinol. 2018 Jul;6(7):547-554
pubmed: 29661699
Lancet. 2020 Sep 19;396(10254):819-829
pubmed: 32877652
J Am Soc Nephrol. 2020 May;31(5):907-919
pubmed: 32276962