Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrumof heart failure risk in the EMPA-REG OUTCOME (R) trial

Aims Empagliflozin reduced the risk of cardiovascular (CV) death and heart failure (HF) hospitalizations in patients with type 2 diabetes (T2D) and established CV disease (CVD) in the EMPA-REG OUTCOME (R) trial. We investigated whether the benefit of empagliflozin was observed across the spectrum of...

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Autores: Fitchett, D, Butler, J, van de Borne, P, Zinman, B, Lachin, JM, Wanner, C, Woerle, HJ, Hantel, S, George, JT, Johansen, OE, Inzucchi, SE, Aizenberg, D, Ulla, M, Waitman, J, De Loredo, L, Farias, J, Fideleff, H, Lagrutta, M, Maldonado, N, Colombo, H, Pacora, FF, Wasserman, A, Maffei, L, Lehman, R, Selvanayagam, J, d'Emden, M, Fasching, P, Paulweber, B, Toplak, H, Luger, A, Drexel, H, Prager, R, Schnack, C, Schernthaner, G, Fliesser-Gorzer, E, Kaser, S, Scheen, A, Van Gaal, L, Hollanders, G, Kockaerts, Y, Capiau, L, Chachati, A, Persu, A, Hermans, M, Vantroyen, D, Vercammen, C, Van de Borne, P, Mathieu, C, Benhalima, K, Lienart, F, Mortelmans, J, Strivay, M, Vereecken, G, Keymeulen, B, Lamkanfi, F, Chacra, A, Eliaschewitz, F, Zanella, M, Faludi, A, Bertolami, M, Hayashida, C, Salles, JN, Monte, O, Dinato, M, Manenti, E, Rassi, N, Halpern, A, Lima, M, Ayoub, J, Felicio, J, Borges, J, Gross, J, Sgarbi, J, Betti, R, Tiburcio, A, Purisch, S, Schmid, H, Takahashi, M, Castro, M, Rea, R, Hissa, M, Neto, BG, Saraiva, J, Henein, S, Lochnan, H, Imran, SA, Clayton, D, Bayly, K, Berlingieri, J, Boucher, P, Chan, Y, Gupta, M, Chehayeb, R, Ouellett, A, Ur, E, Woo, V, St Amour, E, Lozano, MT, Lozno, HY, Urina, M, Jaramillo, PL, Jaramillo, N, Sanchez, G, Perez, G, Tusek, S, Mirosevic, G, Goldoni, V, Jurisic-Erzen, D, Balasko, A, Balic, S, Drvodelic-Sunic, E, Varzic, SC, Machkova, M, Weiner, P, Lastuvka, J, Olsovsky, J, Krarup, T, Ridderstrale, M, Tarnow, L, Boesgaard, TW, Lihn, AS, Christensen, P, Juhl, H, Urhammer, S, Lund, P, Adojaan, B, Jakovlev, U, Lanno, R, Lubi, M, Marandi, T, Gouet, D, Courreges, J, Zaoui, P, Choukroun, G, Petit, C, Formagne, L, Estour, B, Mabire, P, Daugenet, C, Lemarie, B, Clavel, S, Aure, P, Remaud, P, Halimi, J, Hadjadj, S, Couffinhal, T, Glonti, S, Metreveli, D, Lominadze, Z, Giorgadze, E, Burtchuladze, T, Javashvili, L, Kurashvili, G, Kurashvili, R, Virsaladze, D, Nadareishvili, L, Khomasuridze, A, Cahill, T, Green, F, MacRury, S, Waldron, M, Middleton, A, McKnight, J, Pearson, E, Butler, M, Choksi, M, Caldwell, I, Farmer, I, Wyatt, N, Patrick, J, O'Brien, I, Devers, M, Bousboulas, S, Pappas, S, Piaditis, G, Vryonidou, A, Tentolouris, N, Karamitsos, K, Manes, C, Benroubi, M, Avramidis, I, Ozaki, R, Tan, K, Siu, S, Tsang, C, Dudas, M, Nagy, K, Salamon, C, Ip, T, Geroo, L, Patkay, J, Tabak, A, Juhasz, F, Szentpeteri, I, Tamas, G, Ghaisas, N, Bantwal, G, Mohan, V, Gupta, J, Sadhu, N, Kulkarni, A, Garg, N, Reddy, S, Deshpande, N, Gutlapalli, K, Pillai, M, Premchand, R, Badgandi, M, Jain, S, Aravind, S, Shamanna, P, Pandey, A, Gupta, S, Pramono, B, Saksono, HD, Agung, P, Wahono, SD, Suastika, K, Tanggo, Y, Juwana, Y, Siswanto, B, Adawi, F, Efrati, S, Mazen, E, Bashkin, A, Herskovits, T, Jaffe, A, Schiff, E, Wainstein, J, Taddei, S, Aiello, A, Arca, M, Calabro, P, Cignarelli, M, Fioretto, P, Reggiani, GM, Gnasso, A, Marchionni, N, Marsilii, A, Bucci, M, Mezzetti, A, Pozzilli, P, Colivicchi, F, Santini, M, Moro, E, Toscano, V, Fucili, A, Semplicini, A, Monno, S, Furui, K, Higashiue, S, Hiramatsu, N, Kawamitsu, K, Takenaka, T, Takahashi, H, Hojo, F, Onishi, Y, Izumino, K, Okubo, M, Wakida, Y, Kondo, Y, Hieshima, K, Jinnouchi, H, Suzuki, A, Ito, M, Park, S, Kim, Y, Hong, T, Park, H, Gwon, H, Kim, H, Kang, K, Jeong, M, Seung, K, Lim, D, Rha, S, Tahk, S, Yang, J, Yoon, J, Shin, M, Kim, D, Jeong, J, Ahmad, NN, Mustafa, N, Mohamed, WW, Fung, Y, Ghani, RA, Chandramouli, A, Chee, K, Kadir, KA, Ling, K, Abu Hassan, M, Foo, S, Lee, S, Hernandez, PG, Aguilar-Salinas, C, Velazquez, MV, Flores, F, Salazar, MA, Escalante, DM, Soria, MG, Munoz, EC, Storms, G, Schaper, N, Kooy, A, Krekels, M, van Bemmel, T, Verhoeven, R, Mulder, H, Oldenburg-Ligtenberg, P, Gonkel, F, de Jong, A, van Soest, J, Viergever, P, Mevissen, H, Lochorn, G, Zwiers, G, Hoogslag, P, Ronner, E, Nierop, P, Al-Windy, N, Kragten, J, Dekelver, P, Benatar, J, Krebs, J, Scott, R, Heggen, E, Berz, A, Fossum, C, Hurtig, U, Langslet, G, Baranowski, M, Sparby, J, Karlsson, T, Torres, CD, Escudero, AR, Lisson, R, Maldonado, AA, Rojas, WG, Bravo, LG, Osores, JL, Farfan, J, Zapata, L, Junchaya, JG, Concha, YR, Calderon, JU, Sy, R, Tan, G, Aquitania, G, De Los Santos, G, Panelo, A, Roderos, O, Rosales, R, Toledo, R, Liwag, A, Ramoncito, H, Skokowska, E, Krzyzagorska, E, Ogorek, M, Wojnowski, L, Spyra, J, Konieczny, M, Piesiewicz, W, Kus, W, Ocicka-Kozakiewicz, A, Orlowska-Kunikowska, E, Zmuda, W, Duarte, S, Leitao, A, Monteiro, P, Rita, H, Salgado, V, Pinto, L, Queiros, J, Teixeira, J, Rogado, C, Duarte, R, do Rosario, FS, Silva, A, Andrade, L, Velez, M, Brazao, M, Istratoaie, O, Lichiardopol, R, Catrinoiu, D, Militaru, C, Zetu, C, Barbonta, D, Cosma, D, Crisan, C, Pop, L, Esip, V, Khetagurova, F, Petrov, A, Arutyunov, G, Boyarkin, M, Agafyina, A, Vorokhobina, N, Petunina, N, Libov, I, Zalevskaya, A, Nikolaev, K, Barbarash, O, Potemkin, V, Bystrova, A, Krasilnikova, E, Barbarich, V, Chumakova, G, Tarasov, N, Meleshkevich, T, Zateyshchikov, D, Lantseva, O, Belenkiy, D, Obrezan, A, Rossolko, L, Fillipova, E, Yakhontova, P, Khokhlov, A, Tan, R, Sum, C, Chang, H, Distiller, L, Pretorius, M, Nortje, H, Mitha, E, Burgess, L, Blignaut, S, Venter, T, Moodley, R, Lombaard, J, Govind, U, Naidoo, V, Mookadam, M, Engelbrecht, J, Omar, M, Jurgens, J, Podgorski, G, Vawda, H, Naidoo, D, Emanuel, S, Roodt, A, Amod, A, Van Zyl, L, Segura, J, Brito, M, Fernandez-Cruz, A, Artola, S, Iglesias, R, Toural, E, Garcia-Ortiz, L, Saban, J, Mesa, J, Vidal, J, Linares, J, del Canizo, F, Rigla, M, Suarez, C, Llorente, I, Moreno, B, Antoli, A, Peralta, FG, Iglesias, M, Pereg, V, de Teresa, L, Camafort, M, Trescoli, C, Satarasinghe, R, Somasundaram, N, Siyambalapitiya, S, Antonypillai, C, Bulugahapitiya, D, Medagama, U, Huang, C, Lu, Y, Hwang, J, Chiang, C, Wen, M, Chen, J, Lai, W, Chang, K, Wang, J, Yeh, H, Kriangsak, P, Deerochanawong, C, Suwanwalaikorn, S, Mangklabruks, A, Kaewsuwanna, P, Piyayotai, D, Iabluchanskyi, M, Samoylov, O, Godlevska, O, 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Anspach, R, Shah, S, Brusco, O, Naidu, J, Lindenbaum, J, Jacks, R, Hammond, G, Arena, C, Saxman, K, Mach, M, Kerstein, H, Kereiakes, D, Wahlen, J, Wehmeier, K, Chaykin, L, Rothman, J, Fogelfeld, L, Stroger, JH, Bittar, N, Rosenstock, J, Kayne, D, Navarro, J, Colfer, H, Mokshagundam, S, Shandilya, L, Connery, L, Wysham, C, Dela Llana, A, Jardula, M, MacAdams, M, Flippo, G, Heurich, E, Curtis, C, Sanders, D, Rawls, R, Velazquez, F, Osea, E, Mahood, K, Feldman, G, Eder, F, Riley, E, Fowler, W, Jain, M, Shepard, M, Schear, M, Barker, B, Strout, C, Obiekwe, O, Shanik, M, Green, C, Blakney, E, Roberson, K, Bretton, E, Pish, R, Kaveh, K, Maynard, B, Barager, W, Soldyshev, R, Austin, B, Parmar, P, Simpson, R, Chauhan, A, Kasper, J, Burr, R, Patel, N, Mariano, H, Pluto, T, Bratcher, C, Juarez, M, Levinson, L, Awad, A, Longshaw, K, Hoffman, K, Richwine, R, Molter, D, Boscia, J, Kowalyk, S, Lemis, P, Liss, J, Orr, R, Riser, J, Wood, J, Ubani, A, Paine, W, Hassani, F, Miranda, F, Hansen, V, Hansen, VR, Farris, N, Bowden, R, Ajani, D, Maw, K, Andersen, J, Bergman, B, Dunmyer, S, Brandon, D, Anderson, M, Bononi, P, Prawer, J, Seidman, B, Cruz, H, Wilks, K, DiSanto, L, Buynak, R, Christensen, T, Denker, P, Koppel, W, Stedman, M, Lewy-Alterbaum, L, Karim, S, Shapiro, J, Gardner, T, Oskin, T, Gabra, N, Malano, J
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p4143
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/4143
Access Level:acceso abierto
Palabra clave:Type 2 diabetes
Heart failure
Cardiovascular disease
Hospitalization
Mortality
Descripción
Sumario:Aims Empagliflozin reduced the risk of cardiovascular (CV) death and heart failure (HF) hospitalizations in patients with type 2 diabetes (T2D) and established CV disease (CVD) in the EMPA-REG OUTCOME (R) trial. We investigated whether the benefit of empagliflozin was observed across the spectrum of HF risk. Methods and results Seven thousand and twenty patients with T2D (HbA1c 7-10% and eGFR > 30 mL/min/1.73 m(2)) were treated with empagliflozin 10 or 25 mg, or placebo once daily and followed for median 3.1 years. In patients without HF at baseline (89.9%), we derived the 5-year risk for incident HF using the 9-variable Health ABC HF Risk score [classified as low-to-average (<10%), high (10-20%), and very high (>= 20%)]. Overall, 67.2% of the population had low-to-average, 24.2% high, and 5.1% very high 5-year HF risk. Across these groups, the effect on CV death and HF hospitalization with empagliflozin was consistent [hazard ratio 0.71 (95% confidence interval: 0.52, 0.96), 0.52 (0.36, 0.75), and 0.55 (0.30, 1.00), respectively]. Effects on CV death in the ostensibly highest HF risk group (HF at baseline and/or incident HF during the trial) in whom 37.9% of the overall CV deaths occurred, was also beneficial [0.67 (0.47, 0.97)], yet, similar benefits were seen in the lower risk patients. Conclusion In patients with T2D and established CVD, a sizeable proportion without HF at baseline are at high or very high risk for HF outcomes, indicating the need for active case finding in this patient population. Empagliflozin consistently improved HF outcomes both in patients at low or high HF risk.

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