Follow the EMPULSE: In‐hospital initiation of empagliflozin for heart failure across the spectrum of left ventricular ejection fraction
Abstract
This article refers to ‘Treatment effects of empagliflozin in hospitalized heart failure patients across the range of left ventricular ejection fraction – Results from the EMPULSE trial’ by J. Tromp et al. , published in this issue on pages 963–970. Heart failure (HF) is a global pandemic expected to affect over 64 million people worldwide. 1 In the United States, HF accounts for more than 1 million hospitalizations with costs exceeding $40 billion. 1 Researchers and clinicians continue to investigate innovative and effective ways of treating HF. Sodium–glucose cotransporter 2 (SGLT2) inhibitors have emerged as a first-line treatment option for HF. Prior studies have evaluated the benefits of initiating SGLT2 inhibitors in stable ambulatory settings. 2,3 SOLOIST-WHF was the first trial to extrapolate efficacy of sodium–glucose cotransporter inhibition across left ventricular ejection fraction (LVEF) categories but was not exclusive to the acute setting. 4 The landmark EMPULSE trial investigated the efficacy of early initiation of SGLT2 inhibitors specifically in hospitalized patients showing statistical and clinical significance in improving clinical and patient-centred outcomes. 5 In this issue of the Journal, Tromp et al. 6 conducted a post-hoc analysis of the EMPULSE trial and explored the efficacy, safety, and tolerability of empagliflozin across the full range of LVEF.
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