TY - JOUR
T1 - Effect of Empagliflozin on Heart Failure Outcomes after Acute Myocardial Infarction
T2 - Insights from the EMPACT-MI Trial
AU - Hernandez, Adrian F.
AU - Udell, Jacob A.
AU - Jones, W. Schuyler
AU - Anker, Stefan D.
AU - Petrie, Mark C.
AU - Harrington, Josephine
AU - Mattheus, Michaela
AU - Seide, Svenja
AU - Zwiener, Isabella
AU - Amir, Offer
AU - Bahit, M. Cecilia
AU - Bauersachs, Johann
AU - Bayes-Genis, Antoni
AU - Chen, Yundai
AU - Chopra, Vijay K.
AU - Figtree, Gemma A.
AU - Ge, Junbo
AU - Goodman, Shaun G.
AU - Gotcheva, Nina
AU - Goto, Shinya
AU - Gasior, Tomasz
AU - Jamal, Waheed
AU - Januzzi, James L.
AU - Jeong, Myung Ho
AU - Lopatin, Yuri
AU - Lopes, Renato D.
AU - Merkely, Béla
AU - Parikh, Puja B.
AU - Parkhomenko, Alexander
AU - Ponikowski, Piotr
AU - Rossello, Xavier
AU - Schou, Morten
AU - Simic, Dragan
AU - Steg, Philippe Gabriel
AU - Szachniewicz, Joanna
AU - Van Der Meer, Peter
AU - Vinereanu, Dragos
AU - Zieroth, Shelley
AU - Brueckmann, Martina
AU - Sumin, Mikhail
AU - Bhatt, Deepak L.
AU - Butler, Javed
N1 - Publisher Copyright:
© 2024 The Authors.
PY - 2024/5/21
Y1 - 2024/5/21
N2 - BACKGROUND: Empagliflozin reduces the risk of heart failure (HF) events in patients with type 2 diabetes at high cardiovascular risk, chronic kidney disease, or prevalent HF irrespective of ejection fraction. Whereas the EMPACT-MI trial (Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients With Acute Myocardial Infarction) showed that empagliflozin does not reduce the risk of the composite of hospitalization for HF and all-cause death, the effect of empagliflozin on first and recurrent HF events 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 HF on the basis of newly developed left ventricular ejection fraction of <45% 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 HF outcomes. RESULTS: Over a median follow-up of 17.9 months, the risk for first HF hospitalization and total HF hospitalizations was significantly lower in the empagliflozin compared with the placebo group (118 [3.6%] versus 153 [4.7%] patients with events; hazard ratio, 0.77 [95% CI, 0.60, 0.98]; P=0.031, for first HF hospitalization; 148 versus 207 events; rate ratio, 0.67 [95% CI, 0.51, 0.89]; P=0.006, for total HF hospitalizations). Subgroup analysis showed consistency of empagliflozin benefit across clinically relevant patient subgroups for first and total HF hospitalizations. The need for new use of diuretics, renin-Angiotensin modulators, or mineralocorticoid receptor antagonists after discharge was less in patients randomized to empagliflozin versus placebo (all P<0.05). CONCLUSIONS: Empagliflozin reduced the risk of HF in patients with left ventricular dysfunction or congestion after acute myocardial infarction. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04509674.
AB - BACKGROUND: Empagliflozin reduces the risk of heart failure (HF) events in patients with type 2 diabetes at high cardiovascular risk, chronic kidney disease, or prevalent HF irrespective of ejection fraction. Whereas the EMPACT-MI trial (Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients With Acute Myocardial Infarction) showed that empagliflozin does not reduce the risk of the composite of hospitalization for HF and all-cause death, the effect of empagliflozin on first and recurrent HF events 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 HF on the basis of newly developed left ventricular ejection fraction of <45% 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 HF outcomes. RESULTS: Over a median follow-up of 17.9 months, the risk for first HF hospitalization and total HF hospitalizations was significantly lower in the empagliflozin compared with the placebo group (118 [3.6%] versus 153 [4.7%] patients with events; hazard ratio, 0.77 [95% CI, 0.60, 0.98]; P=0.031, for first HF hospitalization; 148 versus 207 events; rate ratio, 0.67 [95% CI, 0.51, 0.89]; P=0.006, for total HF hospitalizations). Subgroup analysis showed consistency of empagliflozin benefit across clinically relevant patient subgroups for first and total HF hospitalizations. The need for new use of diuretics, renin-Angiotensin modulators, or mineralocorticoid receptor antagonists after discharge was less in patients randomized to empagliflozin versus placebo (all P<0.05). CONCLUSIONS: Empagliflozin reduced the risk of HF in patients with left ventricular dysfunction or congestion after acute myocardial infarction. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04509674.
KW - heart failure
KW - hospitalization
KW - myocardial infarction
UR - https://www.scopus.com/pages/publications/85192082139
U2 - 10.1161/CIRCULATIONAHA.124.069217
DO - 10.1161/CIRCULATIONAHA.124.069217
M3 - Article
C2 - 38581389
AN - SCOPUS:85192082139
SN - 0009-7322
VL - 149
SP - 1627
EP - 1638
JO - Circulation
JF - Circulation
IS - 21
ER -