Empagliflozin reduces the risk of mortality and hospitalization for heart failure across Thrombolysis In Myocardial Infarction Risk Score for Heart Failure in Diabetes categories: Post hoc analysis of the EMPA-REG OUTCOME trial
Abstract
Abstract Aim To investigate the association of the Thrombolysis In Myocardial Infarction (TIMI) Risk Score for Heart Failure in Diabetes (TRS‐HF DM ) with mortality using data from the EMPA‐REG OUTCOME trial. Materials and Methods In EMPA‐REG OUTCOME, patients with type 2 diabetes and atherosclerotic cardiovascular (CV) disease (N = 7020) received the sodium‐glucose co‐transporter‐2 inhibitor, empagliflozin, 10 or 25 mg or placebo. Post hoc , patients were stratified into risk categories (low‐intermediate, high, very‐high risk scores) using baseline TRS‐HF DM . Cox regression analyses evaluated the association of TRS‐HF DM categories with all‐cause mortality (ACM), CV death, hospitalization for heart failure (HHF) and CV death (excluding fatal stroke) or HHF, and whether empagliflozin reduced the risk of CV outcomes across these risk categories. Results In placebo patients, increasing risk category was associated with a higher risk of ACM, CV death, and HHF. Empagliflozin reduced the risk of ACM (low‐intermediate HR 0.68 [95% CI 0.48, 0.97] and very‐high 0.69 [0.52, 0.91]), CV death (0.75 [0.48, 1.18] and 0.56 [0.41, 0.78]), HHF (0.53 [0.28, 1.01] and 0.67 [0.48, 0.96]), and CV death or HHF (0.69 [0.46, 1.03]) and (0.64 [0.49, 0.82]) across all risk categories versus placebo. Higher absolute risk reductions (ARRs) were observed for CV death in the very‐high versus low‐intermediate category ( P = 0.01). Conclusions Applied to EMPA‐REG OUTCOME, higher TRS‐HF DM was associated…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 7,020 participants or records.
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