19-LB: Consistent Cardiovascular (CV) Benefits from Empagliflozin across the Spectrum of CV Risk Factor Control: Post Hoc Analysis from EMPA-REG OUTCOME
Abstract
In the EMPA-REG OUTCOME trial of 7020 patients with T2DM and CV disease, empagliflozin (EMPA) significantly reduced risk for 3P-MACE, CV death, hospitalization for heart failure (HHF) and the composite of HHF or CV death, compared to placebo (PBO). We explored these outcomes in subgroups based on achievement of 7 CV risk factor goals at baseline, defined as: HbA1c Within the PBO group alone, the hazard ratio (HR) for 3P-MACE was 2.21 (95% CI 1.53, 3.19) and 1.42 (1.06, 1.89) for patients achieving 0-3 or 4-5 risk factor goals at baseline, respectively, compared to those reaching 6-7. Similarly, patients achieving only 0-3 or 4-5 goals had increased risk for CV death (HR 4.00 [2.26, 7.11] and 2.48 [1.52, 4.06], respectively), HHF or CV death (HR 2.89 [1.82, 4.57] and 1.90 [1.31, 2.78]) and an increased point estimate for HHF (HR 1.91 [0.96, 3.79] and 1.67 [1.00, 2.80]) versus those achieving 6-7 goals at baseline. EMPA consistently reduced the risk for these CV events versus PBO across all subgroups (p for interaction=NS for all; Figure). In conclusion, CV risk increases with fewer CV risk factors controlled, but the cardioprotective effect of EMPA was consistent regardless of the number of risk factors controlled. Disclosure S.E. Inzucchi: Consultant; Self; vTv Therapeutics, Zafgen, Inc. Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Novo Nordisk A/S, Sanofi. K. Khunti: Advisory Panel; Self; Amgen Inc.,…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis. 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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