The EMPEROR-Preserved trial explored the effect of the SGLT2 inhibitor empagliflozin in people living with heart failure with preserved ejection fraction (HFpEF), a condition which to date has had no compelling evidence-based interventions to reduce morbidity and mortality. After a median follow-up of 26 months, the primary endpoint (a composite of cardiovascular death or hospitalisation for HF) was significantly reduced by 21% with empagliflozin compared to placebo (absolute risk reduction, 3.3%; number needed to treat, 30). This was mainly driven by a significant reduction in hospitalisation for HF, as there were no statistically significant reductions in cardiovascular or all-cause death. Empagliflozin is the first therapeutic agent to robustly demonstrate statistically and clinically significant benefits in people living with HFpEF. These results should change clinical practice promptly given that SGLT2 inhibitors are already in widespread clinical use.
Click here to read Kevin Fernando’s discussion of the results in Diabetes Distilled.