- For heart failure with reduced ejection fraction (HFrEF), the sodium-glucose co-transporter-2 (SGLT2) inhibitors empagliflozin and dapagliflozin are consistently linked to improved outcomes in this meta-analysis.
- These authors assessed data from DAPA-HF and EMPEROR-Reduced, evaluating mortality, heart failure hospitalization (HHF), and renal outcomes in different subgroups.
Why this matters
- These authors say that the findings support use of these SGLT2 inhibitors to improve event-free survival in patients with HFrEF.
- In the combined patient population from the 2 trials (n=8474), pooled HRs (95% CIs) with treatment:
- 0.87 (0.77-0.98) for all-cause death;
- 0.86 (0.76-0.98) for cardiovascular death;
- 0.74 (0.68-0.82) for combined cardiovascular death/first HHF;
- 0.75 (0.68-0.84) for combined recurrent HHF or cardiovascular death.
- 0.62 (0.43-0.90) for the composite renal endpoint.
- Benefit was consistent across subgroups (e.g., sex, diabetes, baseline estimated glomerular filtration rate).
- Potential interactions of treatment seen with heart failure functional class (P for interaction=.0087), white race (P for interaction=.0063), and European region (P for interaction=.037).
- Prespecified meta-analysis of the 2 trials.
- Funding: Boehringer Ingelheim.
- Analysis did not access all individual patient data.
- No correction for multiple testing in subgroup analyses, so results should be considered hypothesis-generating.