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Empagliflozin During Hospitalization Improves Acute Heart Failure Symptoms by 15 Days

Mikhail Kosiborod, MD, discusses EMPULSE findings supporting hospital-stage treatment with the SGLT-2—regardless of patients' diabetes status.

Empagliflozin initiated in the hospital for patients with early acute heart failure showed significant improvements in patients symptoms, physical ability and quality of life within 15 days, according to new findings from the EMPULSE trial.

In new research presented at the American College of Cardiology (ACC) 2022 Scientific Sessions in Washington, DC, hospitalized patients with acute heart failure showed significant, early and sustained benefit per Kansas City Cardiomyopathy Questionnaire (KCCQ) scores when treated with empagliflozin.

The findings continue to build evidence for use of the SGLT-2 inhibitor for treating heart failure in a variety of clinical settings, at differing presentations of heart failure, and regardless of a full spectrum of relevant comorbidities.

In an interview with HCPLive during ACC 2022, study author Mikhail Kosiborod, cardiologist and vice president of research at Saint Luke’s Health System, reviewed the previously-published main results of the EMPULSE trial, which showed empagliflozin’s significant benefit for composite cardiovascular outcomes among patients hospitalized with heart failure.

Kosiborod called EMPULSE “different from other SGLT-2 trials” given its focus on the hospitalized acute heart failure patient population, as well as its inclusion of patients with both preserved and reduced ejection fraction, as well as those with and without comorbid diabetes.

“Those that come into the hospital, many of them have worsening of chronic heart failure, but there are a large proportion who have a diagnose of acute heart failure who did not have heart failure previously,” Kosiborod said. “So it really fits a unique niche within the heart failure trials of SGLT-2 inhibitors.”

Regarding the impact of these newest EMPULSE data, Kosoiborod expressed confidence in empagliflozin’s benefit for symptom and physical limitation burden, as well as quality of life, for some of the most acutely-ill heart failure patients.

“As far as I’m concerned, I think the data are compelling—also now in the hospitalized setting—and there is more data emerging,” Kosiborod said. “But I think we have, between SOLOIST and EMPULSE, clearly emerging data suggesting that we should be thinking about starting these medications in the hospital in patients with heart failure regardless of ejection fraction and regardless of comorbidities.”

The study, “A Study to Test the Effect of Empagliflozin in Patients Who Are in Hospital for Acute Heart Failure,” was presented at ACC 2022.