Effect of Empagliflozin on Heart Failure Outcomes After an Acute Myocardial Infarction
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Empagliflozin reduces the risk of heart failure events in patients with type 2 diabetes at high cardiovascular risk, chronic kidney disease, and in those with prevalent heart failure irrespective of ejection fraction. While EMPACT-MI showed empagliflozin does not reduce the risk of the composite of hospitalization of heart failure and all-cause mortality, the impact of empagliflozin on first and recurrent heart failure events in patients after myocardial infarction is unknown.
METHODS
EMPACT-MI was a double-blind, randomized, placebo-controlled, event-driven trial that randomized 6522 patients hospitalized for acute myocardial infarction at risk for heart failure based on newly developed left ventricular ejection fraction of <45% and/or signs or symptoms of congestion to receive empagliflozin 10 mg daily or placebo within 14 days of admission. In prespecified secondary analyses, treatment groups were analyzed for heart failure outcomes.
RESULTS
Over a median of follow-up of 17.9 months, the risk for first heart failure hospitalization and total heart failure hospitalizations was significantly lower in the empagliflozin compared with the placebo group (118 (3.6%) vs. 153 (4.7%) patients with events, HR 0.77 [95% CI 0.60, 0.98], P=0.031 for first heart failure hospitalization and 148 vs. 207 events, RR 0.67 [95% CI 0.51, 0.89], P=0.006 for total heart failure hospitalizations). Subgroup analysis showed consistency of empagliflozin benefit across clinically relevant patient subgroups for first and total heart failure hospitalizations. Post-discharge need for new use of diuretics, renin-angiotensin modulators, and mineralocorticoid receptor antagonists were less in patients randomized to empagliflozin than placebo (all p<0.05).
CONCLUSIONS
In patients after acute myocardial infarction with left ventricular dysfunction or congestion, empagliflozin reduced the risk of heart failure.
Click on any of these tags to subscribe to Topic Alerts. Once subscribed, you can get a single, daily email any time PracticeUpdate publishes content on the topics that interest you.
Visit your Preferences and Settings section to Manage All Topic Alerts
Additional Info
Disclosure statements are available on the authors' profiles:
Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights from the EMPACT-MI Trial
Circulation 2024 Apr 06;[EPub Ahead of Print], AF Hernandez, JA Udell, WS Jones, SD Anker, MC Petrie, J Harrington, M Mattheus, S Seide, I Zwiener, O Amir, MC Bahit, J Bauersachs, A Bayes-Genis, Y Chen, VK Chopra, G Figtree, J Ge, S Goodman, N Gotcheva, S Goto, T Gasior, W Jamal, JL Januzzi, MH Jeong, Y Lopatin, RD Lopes, B Merkely, PB Parikh, A Parkhomenko, P Ponikowski, X Rossello, M Schou, D Simic, PG Steg, J Szachniewicz, P van der Meer, D Vinereanu, S Zieroth, M Brueckmann, M Sumin, DL Bhatt, J ButlerFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.