A double-blind, randomized trial revealed that empagliflozin reduced the combined risk of cardiovascular death or hospitalization for heart failure (HF) in patients with HF and a preserved ejection fraction (HFpEF), regardless of the presence or absence of diabetes. The trial included 5988 patients (average 72 years, about 45% women, and about 49% with diabetes) with class II–IV HF and an ejection fraction of more than 40% to receive empagliflozin (10 mg once daily) or placebo, in addition to standard care. Over a median of 26.2 months, a primary outcome event (a composite of cardiovascular death or hospitalization for HF) occurred in 13.8% and 17.1% in the empagliflozin and in the placebo groups (hazard ratio, 0.79), respectively, mainly due to a lower risk of hospitalization for HF in the empagliflozin group. The effects of empagliflozin appeared consistent in patients with or without diabetes. The total number of hospitalizations for HF was lower in the empagliflozin group (407) than in the placebo group (541; hazard ratio, 0.73). Uncomplicated genital and urinary tract infections and hypotension were reported more frequently with empagliflozin. This is the first trial to show unequivocal benefits of any drug on major HF outcomes in HFpEF patients. It is known that empagliflozin reduces the risk of hospitalization for HF in patients with HF and a reduced ejection fraction. Source: https://www.nejm.org/
