Does Better Kidney Function Mediate Empagliflozin's Benefit in Heart Failure?

It's unlikely — and empagliflozin's effect on renal outcomes is clearly not a reliable surrogate for its effect on heart failure outcomes.

Sodium–glucose cotransporter-2 (SGLT-2) inhibitors improve renal outcomes in patients with diabetes, but their renal effects for people with heart failure (HF) are still being discussed. Some experts believe that the effect on renal outcomes can be used as a surrogate marker for the effect on HF outcomes. Also, the mechanism of benefit in HF is not clear and may be mediated through renal effects.

Investigators combined data from the manufacturer-sponsored EMPEROR-Reduced (NEJM JW Cardiol Oct 2020 and N Engl J Med 2020; 383:1413) and EMPEROR-Preserved (NEJM JW Cardiol Oct 2021 and N Engl J Med 2021 Aug 27; [e-pub]) trials, which studied the effect of the SGLT-2 inhibitor empagliflozin on HF outcomes across a range of ejection fractions.

The an…

Reviewing Author

Harlan M. Krumholz, MD, SM

Disclosures

Consultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime

EquityHugo Health; Refactor Health; Element Science

Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association

Harlan M. Krumholz, MD, SM

Disclosures

Consultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime

EquityHugo Health; Refactor Health; Element Science

Does Better Kidney Function Mediate Empagliflozin's Benefit in Heart Failure?

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Reviewing Author