Empagliflozin for Patients with Heart Failure and Volume Overload?

Sodium–glucose cotransporter-2 (SGLT-2) inhibitors have diuretic properties, but does that mean that these drugs improve outcomes more effectively in patients with heart failure with reduced ejection fraction (HFrEF) and volume overload than in patients without volume overload? To find out, researchers performed a secondary analysis of the manufacturer-supported EMPEROR-Reduced trial, which randomized 3730 subjects with HFrEF to empagliflozin (10 mg daily) or placebo (NCT03057977). Almost 40% of subjects had volume overload in the 4 weeks prior to enrollment; 50% had diabetes.

Unsurprisingly, patients with volume overload were more likely than those without volume overload to have been hospitalized or to have received an intravenous diuretic…