Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrumof heart failure risk in the EMPA-REG OUTCOME (R) trial

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Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrumof heart failure risk in the EMPA-REG OUTCOME (R) trial. / EMPA-REG OUTCOME Investigators.

In: European Heart Journal, Vol. 39, No. 5, 01.02.2018, p. 363-370.

Research output: Contribution to journal › Article › peer-review

BibTeX

@article{ef564059b6614213bec4b90378ffc2ac,

title = "Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrumof heart failure risk in the EMPA-REG OUTCOME (R) trial",

abstract = "Aims Empagliflozin reduced the risk of cardiovascular (CV) death and heart failure (HF) hospitalizations in patients with type 2 diabetes (T2D) and established CV disease (CVD) in the EMPA-REG OUTCOME (R) trial. We investigated whether the benefit of empagliflozin was observed across the spectrum of HF risk.Methods and results Seven thousand and twenty patients with T2D (HbA1c 7-10% and eGFR > 30 mL/min/1.73 m(2)) were treated with empagliflozin 10 or 25 mg, or placebo once daily and followed for median 3.1 years. In patients without HF at baseline (89.9%), we derived the 5-year risk for incident HF using the 9-variable Health ABC HF Risk score [classified as low-to-average (= 20%)]. Overall, 67.2% of the population had low-to-average, 24.2% high, and 5.1% very high 5-year HF risk. Across these groups, the effect on CV death and HF hospitalization with empagliflozin was consistent [hazard ratio 0.71 (95% confidence interval: 0.52, 0.96), 0.52 (0.36, 0.75), and 0.55 (0.30, 1.00), respectively]. Effects on CV death in the ostensibly highest HF risk group (HF at baseline and/or incident HF during the trial) in whom 37.9% of the overall CV deaths occurred, was also beneficial [0.67 (0.47, 0.97)], yet, similar benefits were seen in the lower risk patients.Conclusion In patients with T2D and established CVD, a sizeable proportion without HF at baseline are at high or very high risk for HF outcomes, indicating the need for active case finding in this patient population. Empagliflozin consistently improved HF outcomes both in patients at low or high HF risk.",

keywords = "Type 2 diabetes, Heart failure, Cardiovascular disease, Hospitalization, Mortality, DIABETES-MELLITUS, PREDICTION, ASSOCIATION, MANAGEMENT, PROGNOSIS, IMPACT",

author = "{EMPA-REG OUTCOME Trial} and David Fitchett and Javed Butler and {van de Borne}, Philippe and Bernard Zinman and Lachin, {John M.} and Christoph Wanner and Woerle, {Hans J.} and Stefan Hantel and George, {Jyothis T.} and Johansen, {Odd Erik} and Inzucchi, {Silvio E.} and D. Aizenberg and M. Ulla and J. Waitman and {De Loredo}, L. and J. Farias and H. Fideleff and M. Lagrutta and N. Maldonado and H. Colombo and {Ferre Pacora}, F. and A. Wasserman and L. Maffei and R. Lehman and J. Selvanayagam and M. d'Emden and P. Fasching and B. Paulweber and H. Toplak and A. Luger and H. Drexel and R. Prager and A. Tiburcio and S. Gupta and S. Park and Y. Kim and J. Yang and D. Kim and S. Lee and A. Petrov and K. Nikolaev and V. Potemkin and A. Bystrova and N. Tarasov and A. Obrezan and A. Khokhlov and C. Huang and J. Chen and J. Wang and S. Zotov",

year = "2018",

month = feb,

day = "1",

doi = "10.1093/eurheartj/ehx511",

language = "Английский",

volume = "39",

pages = "363--370",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "5",

}

RIS

TY - JOUR

T1 - Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrumof heart failure risk in the EMPA-REG OUTCOME (R) trial

AU - EMPA-REG OUTCOME Trial

AU - Fitchett, David

AU - Butler, Javed

AU - van de Borne, Philippe

AU - Zinman, Bernard

AU - Lachin, John M.

AU - Wanner, Christoph

AU - Woerle, Hans J.

AU - Hantel, Stefan

AU - George, Jyothis T.

AU - Johansen, Odd Erik

AU - Inzucchi, Silvio E.

AU - Aizenberg, D.

AU - Ulla, M.

AU - Waitman, J.

AU - De Loredo, L.

AU - Farias, J.

AU - Fideleff, H.

AU - Lagrutta, M.

AU - Maldonado, N.

AU - Colombo, H.

AU - Ferre Pacora, F.

AU - Wasserman, A.

AU - Maffei, L.

AU - Lehman, R.

AU - Selvanayagam, J.

AU - d'Emden, M.

AU - Fasching, P.

AU - Paulweber, B.

AU - Toplak, H.

AU - Luger, A.

AU - Drexel, H.

AU - Prager, R.

AU - Tiburcio, A.

AU - Gupta, S.

AU - Park, S.

AU - Kim, Y.

AU - Yang, J.

AU - Kim, D.

AU - Lee, S.

AU - Petrov, A.

AU - Nikolaev, K.

AU - Potemkin, V.

AU - Bystrova, A.

AU - Tarasov, N.

AU - Obrezan, A.

AU - Khokhlov, A.

AU - Huang, C.

AU - Chen, J.

AU - Wang, J.

AU - Zotov, S.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Aims Empagliflozin reduced the risk of cardiovascular (CV) death and heart failure (HF) hospitalizations in patients with type 2 diabetes (T2D) and established CV disease (CVD) in the EMPA-REG OUTCOME (R) trial. We investigated whether the benefit of empagliflozin was observed across the spectrum of HF risk.Methods and results Seven thousand and twenty patients with T2D (HbA1c 7-10% and eGFR > 30 mL/min/1.73 m(2)) were treated with empagliflozin 10 or 25 mg, or placebo once daily and followed for median 3.1 years. In patients without HF at baseline (89.9%), we derived the 5-year risk for incident HF using the 9-variable Health ABC HF Risk score [classified as low-to-average (= 20%)]. Overall, 67.2% of the population had low-to-average, 24.2% high, and 5.1% very high 5-year HF risk. Across these groups, the effect on CV death and HF hospitalization with empagliflozin was consistent [hazard ratio 0.71 (95% confidence interval: 0.52, 0.96), 0.52 (0.36, 0.75), and 0.55 (0.30, 1.00), respectively]. Effects on CV death in the ostensibly highest HF risk group (HF at baseline and/or incident HF during the trial) in whom 37.9% of the overall CV deaths occurred, was also beneficial [0.67 (0.47, 0.97)], yet, similar benefits were seen in the lower risk patients.Conclusion In patients with T2D and established CVD, a sizeable proportion without HF at baseline are at high or very high risk for HF outcomes, indicating the need for active case finding in this patient population. Empagliflozin consistently improved HF outcomes both in patients at low or high HF risk.

AB - Aims Empagliflozin reduced the risk of cardiovascular (CV) death and heart failure (HF) hospitalizations in patients with type 2 diabetes (T2D) and established CV disease (CVD) in the EMPA-REG OUTCOME (R) trial. We investigated whether the benefit of empagliflozin was observed across the spectrum of HF risk.Methods and results Seven thousand and twenty patients with T2D (HbA1c 7-10% and eGFR > 30 mL/min/1.73 m(2)) were treated with empagliflozin 10 or 25 mg, or placebo once daily and followed for median 3.1 years. In patients without HF at baseline (89.9%), we derived the 5-year risk for incident HF using the 9-variable Health ABC HF Risk score [classified as low-to-average (= 20%)]. Overall, 67.2% of the population had low-to-average, 24.2% high, and 5.1% very high 5-year HF risk. Across these groups, the effect on CV death and HF hospitalization with empagliflozin was consistent [hazard ratio 0.71 (95% confidence interval: 0.52, 0.96), 0.52 (0.36, 0.75), and 0.55 (0.30, 1.00), respectively]. Effects on CV death in the ostensibly highest HF risk group (HF at baseline and/or incident HF during the trial) in whom 37.9% of the overall CV deaths occurred, was also beneficial [0.67 (0.47, 0.97)], yet, similar benefits were seen in the lower risk patients.Conclusion In patients with T2D and established CVD, a sizeable proportion without HF at baseline are at high or very high risk for HF outcomes, indicating the need for active case finding in this patient population. Empagliflozin consistently improved HF outcomes both in patients at low or high HF risk.

KW - Type 2 diabetes

KW - Heart failure

KW - Cardiovascular disease

KW - Hospitalization

KW - Mortality

KW - DIABETES-MELLITUS

KW - PREDICTION

KW - ASSOCIATION

KW - MANAGEMENT

KW - PROGNOSIS

KW - IMPACT

U2 - 10.1093/eurheartj/ehx511

DO - 10.1093/eurheartj/ehx511

M3 - статья

VL - 39

SP - 363

EP - 370

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 5

ER -

ID: 87876006