Empagliflozin, health status, and quality of life in patients with heart failure and preserved ejection fraction: the EMPEROR-preserved trial

BACKGROUND: Patients with heart failure with preserved ejection fraction have significant impairment in health-related quality of life. In the EMPEROR-Preserved trial (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Preserved Ejection Fraction), we evaluated the efficacy of e...

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Main Authors: Butler, Javed (Author) , Filippatos, Gerasimos (Author) , Siddiqi, Tariq Jamal (Author) , Brückmann, Martina (Author) , Bohm, Michael (Author) , Chopra, Vijay K. (Author) , Ferreira, Joao Pedro (Author) , Januzzi, James L. (Author) , Kaul, Sanjay (Author) , Pina, Ileana L. (Author) , Ponikowski, Piotr (Author) , Shah, Sanjiv J. (Author) , Senni, Michele (Author) , Vedin, Ola (Author) , Verma, Subodh (Author) , Peil, Barbara (Author) , Pocock, Stuart J. (Author) , Zannad, Faiez (Author) , Packer, Milton (Author) , Anker, Stefan D. (Author)
Format: Article (Journal)
Language:English
Published: 2022
In: Circulation
Year: 2022, Volume: 145, Issue: 3, Pages: 184-193
ISSN:1524-4539
DOI:10.1161/CIRCULATIONAHA.121.057812
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1161/CIRCULATIONAHA.121.057812
Verlag, lizenzpflichtig, Volltext: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057812
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Author Notes:Javed Butler, Gerasimos Filippatos, Tariq Jamal Siddiqi, Martina Brueckmann, Michael Bohm, Vijay K. Chopra, Joao Pedro Ferreira, James L. Januzzi, Sanjay Kaul, Ileana L. Pina, Piotr Ponikowski, Sanjiv J. Shah, Michele Senni, Ola Vedin, Subodh Verma, Barbara Peil, Stuart J. Pocock, Faiez Zannad, Milton Packer, and Stefan D. Anker

MARC

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245 1 0 |a Empagliflozin, health status, and quality of life in patients with heart failure and preserved ejection fraction  |b the EMPEROR-preserved trial  |c Javed Butler, Gerasimos Filippatos, Tariq Jamal Siddiqi, Martina Brueckmann, Michael Bohm, Vijay K. Chopra, Joao Pedro Ferreira, James L. Januzzi, Sanjay Kaul, Ileana L. Pina, Piotr Ponikowski, Sanjiv J. Shah, Michele Senni, Ola Vedin, Subodh Verma, Barbara Peil, Stuart J. Pocock, Faiez Zannad, Milton Packer, and Stefan D. Anker 
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520 |a BACKGROUND: Patients with heart failure with preserved ejection fraction have significant impairment in health-related quality of life. In the EMPEROR-Preserved trial (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Preserved Ejection Fraction), we evaluated the efficacy of empagliflozin on health-related quality of life in patients with heart failure with preserved ejection fraction and whether the clinical benefit observed with empagliflozin varies according to baseline health status. METHODS: Health-related quality of life was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) at baseline and 12, 32, and 52 weeks. Patients were divided by baseline KCCQ Clinical Summary Score (CSS) tertiles, and the effect of empagliflozin on outcomes was examined. The effect of empagliflozin on KCCQ-CSS, Total Symptom Score, and Overall Summary Score was evaluated. Responder analyses were performed to compare the odds of improvement and deterioration in KCCQ related to treatment with empagliflozin. RESULTS: The effect of empagliflozin on reducing the risk of time to cardiovascular death or heart failure hospitalization was consistent across baseline KCCQ-CSS tertiles (hazard ratio, 0.83 [95% CI, 0.69-1.00], 0.70 [95% CI, 0.55-0.88], and 0.82 [95% CI, 0.62-1.08] for scores <62.5, 62.5-83.3, and >= 83.3, respectively; P trend=0.77). Similar results were seen for total heart failure hospitalizations. Patients treated with empagliflozin had significant improvement in KCCQ-CSS versus placebo (+1.03, +1.24, and +1.50 at 12, 32, and 52 weeks, respectively; P<0.01); similar results were seen for Total Symptom Score and Overall Summary Score. At 12 weeks, patients on empagliflozin had higher odds of improvement >= 5 points (odds ratio, 1.23 [95% CI, 1.10-1.37]), >= 10 points (odds ratio, 1.15 [95% CI, 1.03-1.27]), and >= 15 points (odds ratio, 1.13 [95% CI, 1.02-1.26]) and lower odds of deterioration >= 5 points in KCCQ-CSS (odds ratio, 0.85 [95% CI, 0.75-0.97]). A similar pattern was seen at 32 and 52 weeks, and results were consistent for Total Symptom Score and Overall Summary Score. CONCLUSIONS: In patients with heart failure with preserved ejection fraction, empagliflozin reduced the risk for major heart failure outcomes across the range of baseline KCCQ scores. Empagliflozin improved health-related quality of life, an effect that appeared early and was sustained for at least 1 year. 
650 4 |a empagliflozin 
650 4 |a health status 
650 4 |a heart failure, diastolic 
650 4 |a mortality 
650 4 |a quality of life 
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700 1 |a Chopra, Vijay K.  |e VerfasserIn  |4 aut 
700 1 |a Ferreira, Joao Pedro  |e VerfasserIn  |4 aut 
700 1 |a Januzzi, James L.  |e VerfasserIn  |4 aut 
700 1 |a Kaul, Sanjay  |e VerfasserIn  |4 aut 
700 1 |a Pina, Ileana L.  |e VerfasserIn  |4 aut 
700 1 |a Ponikowski, Piotr  |e VerfasserIn  |4 aut 
700 1 |a Shah, Sanjiv J.  |e VerfasserIn  |4 aut 
700 1 |a Senni, Michele  |e VerfasserIn  |4 aut 
700 1 |a Vedin, Ola  |e VerfasserIn  |4 aut 
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700 1 |a Zannad, Faiez  |e VerfasserIn  |4 aut 
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700 1 |a Anker, Stefan D.  |e VerfasserIn  |4 aut 
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