A double-blind trial was conducted to assess the effects of empagliflozin in patients with heart failure and preserved ejection fraction. A total of 5,988 patients with class II–IV heart failure and an ejection fraction greater than 40% were randomly assigned to receive either empagliflozin (10 mg daily) or a placebo, in addition to their usual therapy. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure.

Over a median follow-up of 26.2 months, empagliflozin significantly reduced the risk of the primary outcome compared to placebo, with 13.8% of patients in the empagliflozin group experiencing a primary outcome event, vs 17.1% in the placebo group (hazard ratio, 0.79; P<0.001). The reduction was primarily driven by fewer hospitalizations for heart failure in the empagliflozin group. The benefit of empagliflozin was consistent in patients with or without diabetes. However, there was a higher incidence of uncomplicated genital and urinary tract infections and hypotension in the empagliflozin group. In conclusion, empagliflozin reduced the risk of cardiovascular death or hospitalization for heart failure in patients with heart failure and preserved ejection fraction, irrespective of diabetes status.

Reference: Anker SD, Butler J, Filippatos G, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021;385(16):1451-1461. doi: 10.1056/NEJMoa2107038.