Multiple RCTs in patients hospitalised for acute HF have failed to find improved post-discharge
outcomes with pharmacological interventions. It is now known that SGLT2 inhibitors reduce the risk
of CV death or HF hospitalisation in patients with HFrEF or HFpEF. However, the safety and efficacy
of SGLT2 inhibitors in the early phase of hospital admission had not been previously studied. The
EMPULSE trial was designed to investigate the effects of empagliflozin on survival, heart failure
events (HFE) and improvements in symptoms in patients hospitalised for acute HF. The trial’s primary
outcome was clinical benefit, defined as a hierarchical composite of all-cause death, number of
HFE and time to first HFE, or a ≥5 point difference in change from baseline in the KCCQ-TTS
QoL assessment at 90 days, assessed using a win ratio. This review is sponsored by Boehringer
Ingelheim and Eli Lilly.
A free full-text PDF of the paper Voors A.A. et al The SGLT2 inhibitor empagliflozin in patients
hospitalized for acute heart failure: A multinational randomized trial. Nat Med. 2022;28(3):568-574
is available here.
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