Empagliflozin linked to reduced left ventricular mass

  • Verma S & al.
  • Circulation
  • 22 Aug 2019

  • International Clinical Digest
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Takeaway

  • Among people with type 2 diabetes (T2D) and coronary artery disease (CAD), empagliflozin is associated with a significant reduction in left ventricular mass indexed (LVMi) to body surface area (BSA) after 6 months.

Why this matters

  • Underlying mechanisms of empagliflozin’s cardiovascular benefits seen in the EMPA-REG OUTCOME study are unknown.

Study design

  • Study of 97 adults with T2D and CAD were randomly allocated to 10 mg/day empagliflozin or placebo for 6 months.
  • Primary outcome: 6-month change in LVMi to BSA from baseline, per cardiac MRI.
  • Funding: Boehringer Ingelheim grant to authors.

Key results

  • Baseline LVMi: 59.3 g/m2 empagliflozin vs 62.2 g/m2 placebo.
  • LVMi change from baseline to 6 months:
    • −2.6 g/m2 with empagliflozin vs
    • −0.01 g/m2 with placebo;
    • Adjusted between-group difference: −3.4 (−5.9 to −0.8) g/m2 (P=.01).
  • Empagliflozin exposure was associated with mean BP reductions of 7.9 mmHg systolic and 3.1 mmHg diastolic vs no change in placebo group, for differences of:
    • −6.8 mmHg (P=.003) systolic and
    • −3.2 mmHg (P=.016) diastolic.
  • Mean baseline hematocrit:
    • 42.6% empagliflozin vs 41.3% placebo;
    • 6-month increases of 2.4% and 2.8%, respectively;
    • Adjusted difference, 2.3% (P=.0003).   

Limitations

  • Mostly male participants.
  • People with kidney disease, heart failure excluded.
  • Small sample size.
  • Brief follow-up.