RT Journal Article
T1 Left Ventricular Function, Congestion, and Effect of Empagliflozin on Heart Failure Risk After Myocardial Infarction
A1 Udell, Jacob A
A1 Petrie, Mark C
A1 Jones, W Schuyler
A1 Anker, Stefan D
A1 Harrington, Josephine
A1 Mattheus, Michaela
A1 Seide, Svenja
A1 Amir, Offer
A1 Bahit, M Cecilia
A1 Bauersachs, Johann
A1 Bayes-Genis, Antoni
A1 Chen, Yundai
A1 Chopra, Vijay K
A1 Figtree, Gemma
A1 Ge, Junbo
A1 Goodman, Shaun G
A1 Gotcheva, Nina
A1 Goto, Shinya
A1 Gasior, Tomasz
A1 Jamal, Waheed
A1 Januzzi, James L
A1 Jeong, Myung Ho
A1 Lopatin, Yuri
A1 Lopes, Renato D
A1 Merkely, Béla
A1 Martinez-Traba, Monica
A1 Parikh, Puja B
A1 Parkhomenko, Alexander
A1 Ponikowski, Piotr
A1 Rosselló, Xavier
A1 Schou, Morten
A1 Simic, Dragan
A1 Steg, Philippe Gabriel
A1 Szachniewicz, Joanna
A1 van der Meer, Peter
A1 Vinereanu, Dragos
A1 Zieroth, Shelley
A1 Brueckmann, Martina
A1 Sumin, Mikhail
A1 Bhatt, Deepak L
A1 Hernandez, Adrian F
A1 Butler, Javed
AB Empagliflozin reduces the risk of heart failure (HF) hospitalizations but not all-cause mortality when started within 14 days of acute myocardial infarction (AMI).This study sought to evaluate the association of left ventricular ejection fraction (LVEF), congestion, or both, with outcomes and the impact of empagliflozin in reducing HF risk post-AMI.In the EMPACT-MI (Trial to Evaluate the Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients with Acute Myocardial Infarction) trial, patients were randomized within 14 days of an AMI complicated by either newly reduced LVEF<45%, congestion, or both, to empagliflozin (10 mg daily) or placebo and were followed up for a median of 17.9 months.Among 6,522 patients, the mean baseline LVEF was 41 ± 9%; 2,648 patients (40.6%) presented with LVEF <45% alone, 1,483 (22.7%) presented with congestion alone, and 2,181 (33.4%) presented with both. Among patients in the placebo arm of the trial, multivariable adjusted risk for each 10-point reduction in LVEF included all-cause death or HF hospitalization (HR: 1.49; 95% CI: 1.31-1.69; P < 0.0001), first HF hospitalization (HR: 1.64; 95% CI: 1.37-1.96; P < 0.0001), and total HF hospitalizations (rate ratio [RR]: 1.89; 95% CI: 1.51-2.36; P < 0.0001). The presence of congestion was also associated with a significantly higher risk for each of these outcomes (HR: 1.52, 1.94, and RR: 2.03, respectively). Empagliflozin reduced the risk for first (HR: 0.77; 95% CI: 0.60-0.98) and total (RR: 0.67; 95% CI: 0.50-0.89) HF hospitalizations, irrespective of LVEF or congestion, or both. The safety profile of empagliflozin was consistent across baseline LVEF and irrespective of congestion status.In patients with AMI, the severity of left ventricular dysfunction and the presence of congestion was associated with worse outcomes. Empagliflozin reduced first and total HF hospitalizations across the range of LVEF with and without congestion. (Trial to Evaluate the Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients with Acute Myocardial Infarction [EMPACT-MI]; NCT04509674).
PB Elsevier
YR 2024
FD 2024-04-06
LK https://hdl.handle.net/20.500.13003/20330
UL https://hdl.handle.net/20.500.13003/20330
LA eng
NO Udell JA, Petrie MC, Jones WS, Anker SD, Harrington J, Mattheus M, et al. Left Ventricular Function, Congestion, and Effect of Empagliflozin on Heart Failure Risk After Myocardial Infarction. J Am Coll Cardiol. 2024 Apr 6;
DS Docusalut
RD 13 jul. 2026