Kidney Week

Abstract: FR-OR67

EMPEROR-Preserved: Empagliflozin and Outcomes in Heart Failure with a Preserved Ejection Fraction and CKD

Session Information

• High-Impact Clinical Trials
  November 05, 2021 | Location: Live-Stream, Virtual Only
  Abstract Time: 12:00 PM - 12:15 PM

Category: Hypertension and CVD

• 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

• Zannad, Faiez, Université de Lorraine, Inserm INI-CRCT, CHRU, Nancy, France

Faiez Zannad, MD, PhD

• Kraus, Bettina J., University Hospital, Wuerzburg, Germany

Bettina J. Kraus,

• Zeller, Cordula, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer, Germany

Cordula Zeller,

• Pocock, Stuart, London School of Hygiene and Tropical, London, United Kingdom

Stuart Pocock,

• Packer, Milton, Baylor Heart and Vascular Institute, Dallas, Texas, United States

Milton Packer,

• Filippatos, Gerasimos, Attikon University Hospital, Athens, Greece

Gerasimos Filippatos,

• Ferreira, João Pedro, CHRU Nancy - Hopitaux de Brabois, Nancy, France

João Pedro Ferreira,

• Anker, Stefan D., Charité Medical School, Berlin, Germany

Stefan D. Anker,

• Butler, Javed, University of Mississippi, University Park, Mississippi, United States

Javed Butler,

Group or Team Name

• EMPEROR-Preserved Trial Committees and Investigators

Background

In EMPEROR- Preserved, empagliflozin reduced cardiovascular death and heart failure hospitalizations and slowed the progressive decline in glomerular function in heart failure and a preserved ejection fraction (HFpEF), with or without diabetes. We explored the effect of empagliflozin on cardiovascular and kidney endpoints, across the spectrum of kidney function.

Methods

5988 patients were randomized, of whom 3198 (53%) had prevalent chronic kidney disease (CKD) (eGFR<60ml/min/1.73m² or an UACR>300mg/g). The key outcomes were (1) a composite of cardiovascular death or hospitalization for heart failure; (2) total hospitalizations for heart failure, and (3) eGFR slope. The median follow-up was 26 months.

Results

Patients with prevalent CKD had a higher rate of CV and kidney events. Overall, empagliflozin reduced the risk of cardiovascular death and hospitalization for heart failure by 21% (p<0.001), reduced total hospitalizations for heart failure by 27% (p<0.001) and significantly slowed the yearly decline in eGFR (Difference: 1.36 mL/min/1.73 m2 per year, p<0.001). In this present CKD subgroup analysis, all three benefits were seen consistently in patients with and without CKD (figure) and were apparent even in patients with severe impairment (eGFR from 20 to 30ml/min/1.73m²). Empagliflozin was well tolerated regardless of the level of baseline kidney function.

Conclusion

In patients with HFpEF, empagliflozin reduced serious heart failure events and slowed the decline in glomerular function, regardless of the presence or absence of CKD and across a broad spectrum of baseline kidney function.

Funding

• Commercial Support – Boehringer Ingelheim & Eli Lilly and Company Diabetes Alliance