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Implantable cardioverter-defibrillator therapy in contemporary heart failure patients: an analysis from the EMPEROR-reduced trial

Background - The benefit of an implantable cardioverter-defibrillator (ICD) in patients with heart failure with reduced ejection fraction on foundational therapy that includes a sodium-glucose cotransporter 2 inhibitor is unknown. - Objectives - This study aims to evaluate the impact of an ICD among...

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Hauptverfasser: Aktaş, Mehmet K. (Verfasst von) , Talha, Khawaja M. (Verfasst von) , Goldenberg, Ilan (Verfasst von) , Zareba, Wojciech (Verfasst von) , Böhm, Michael (Verfasst von) , Abdin, Amr (Verfasst von) , Brückmann, Martina (Verfasst von) , Zeller, Cordula (Verfasst von) , Zaremba-Pechmann, Liliana (Verfasst von) , Pocock, Stuart (Verfasst von) , Zannad, Faiez (Verfasst von) , Anker, Stefan D. (Verfasst von) , Filippatos, Gerasimos (Verfasst von) , Butler, Javed (Verfasst von) , Ferreira, João Pedro (Verfasst von) , Packer, Milton (Verfasst von)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: August 2026
In: JACC Heart failure
Year: 2026, Jahrgang: 14, Heft: 8, Pages: 1-10
ISSN:2213-1787
DOI:10.1016/j.jchf.2026.103166
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jchf.2026.103166
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2213177926002660
Volltext
Verfasserangaben:Mehmet K. Aktas¸, MD, MBA, Khawaja M. Talha, MD, Ilan Goldenberg, MD, Wojciech Zareba, MD, PHD, Michael Böhm, MD, Amr Abdin, MD, Martina Brueckmann, MD, Cordula Zeller, DIPL-MATH, Liliana Zaremba-Pechmann, PHD, Stuart Pocock, PHD, Faiez Zannad, MD, PHD, Stefan D. Anker, MD, PHD, Gerasimos Filippatos, MD, Javed Butler, MD, MPH, MBA, João Pedro Ferreira, MD, PHD, Milton Packer, MD
Beschreibung
Zusammenfassung:Background - The benefit of an implantable cardioverter-defibrillator (ICD) in patients with heart failure with reduced ejection fraction on foundational therapy that includes a sodium-glucose cotransporter 2 inhibitor is unknown. - Objectives - This study aims to evaluate the impact of an ICD among participants enrolled in EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients with Chronic Heart Failure and a Reduced Ejection Fraction). - Methods - Propensity score matching was used to compare outcomes in patients with and without an ICD in the placebo and empagliflozin arms of the EMPEROR-Reduced trial. Time-to-event curves and Cox regression analysis were used to evaluate the risk of the primary endpoint of sudden cardiac death (SCD). - Results - A total of 1,674 patients were included in the analysis of whom 837 (429 on placebo and 408 on empagliflozin) with an ICD at baseline were matched to 837 (424 on placebo and 413 on empagliflozin) without an ICD. Background therapy included an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor blocker-neprilysin inhibitor (≥88%); beta-blockers (≥94%), and mineralocorticoid receptor antagonists (≥65%). Cox regression analysis showed ICD vs non-ICD treatment was associated with a lower risk of SCD in both the empagliflozin (HR: 0.59; 95% CI: 0.26-1.3) and placebo arms of the trial (HR: 0.31; 95% CI: 0.13-0.74), treatment-by-ICD interaction P = 0.30. - Conclusions - In patients with heart failure with reduced ejection fraction enrolled in EMPEROR-Reduced, those with an ICD (vs non-ICD) experienced a lower risk of SCD regardless of empagliflozin treatment.
Beschreibung:Online verfügbar: 2. Juli 2026, Artikelversion: 3. August 2026
Gesehen am 20.08.2026
Beschreibung:Online Resource
ISSN:2213-1787
DOI:10.1016/j.jchf.2026.103166

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