Baseline characteristics of patients with heart failure with preserved ejection fraction in the EMPEROR-Preserved trial

S.D. Anker*, J. Butler, G. Filippatos, M.S. Khan, J.P. Ferreira, E. Bocchi, M. Bohm, H.P. Brunner-La Rocca, D.J. Choi, V. Chopra, E. Chuquiure, N. Giannetti, J.E. Gomez-Mesa, S. Janssens, J.L. Januzzi, J.R. Gonzalez-Juanatey, B. Merkely, S.J. Nicholls, S.V. Perrone, I.L. PinaP. Ponikowski, M. Senni, M.F. Seronde, D. Sim, J. Spinar, I. Squire, S. Taddei, H. Tsutsui, S. Verma, D. Vinereanu, J. Zhang, W. Jamal, S. Schnaidt, J.M. Schnee, M. Brueckmann, S.J. Pocock, F. Zannad, M. Packer, EMPEROR-Preserved Trial Committees and Investigators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

46 Citations (Web of Science)

Abstract

Aims EMPEROR-Preserved is an ongoing trial evaluating the effect of empagliflozin in patients with heart failure with preserved ejection fraction (HFpEF). This report describes the baseline characteristics of the EMPEROR-Preserved cohort and compares them with patients enrolled in prior HFpEF trials.Methods and results EMPEROR-Preserved is a phase III randomized, international, double-blind, parallel-group, placebo-controlled trial in which 5988 symptomatic HFpEF patients [left ventricular ejection fraction (LVEF) >40%] with and without type 2 diabetes mellitus (T2DM) have been enrolled. Patients were required to have elevated N-terminal pro B-typenatriuretic peptide (NT-proBNP) concentrations (i.e. >300 pg/mL in patients without and >900 pg/mL in patients with atrial fibrillation) along with evidence of structural changes in the heart or documented history of heart failure hospitalization. Among patients enrolled from various regions (45% Europe, 11% Asia, 25% Latin America, 12% North America), the mean age was 72 +/- 9 years, 45% were women. Almost all patients had New York Heart Association class II or III symptoms (99.6%), and 23% had prior heart failure hospitalization within 12 months. Thirty-three percent of the patients had baseline LVEF of 41-50%. The mean LVEF (54 +/- 9%) was slightly lower while the median NT-proBNP [974 (499-1731) pg/mL] was higher compared with previous HFpEF trials. Presence of comorbidities such as diabetes (49%) and chronic kidney disease (50%) were common. The majority of the patients were on angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors (80%) and beta-blockers (86%), and 37% of patients were on mineralocorticoid receptor antagonists.Conclusion When compared with prior trials in HFpEF, the EMPEROR-Preserved cohort has a somewhat higher burden of comorbidities, lower LVEF, higher median NT-proBNP and greater use of mineralocorticoid receptor antagonists at baseline. Results of the EMPEROR-Preserved trial will be available in 2021.
Original languageEnglish
Pages (from-to)2383-2392
Number of pages10
JournalEuropean journal of heart failure
Volume22
Issue number12
DOIs
Publication statusPublished - 1 Dec 2020

Keywords

  • Empagliflozin
  • Heart failure with preserved ejection fraction
  • Sodium&#8211
  • empagliflozin
  • glucose co&#8208
  • heart failure with preserved ejection fraction
  • sodium&#8211
  • transporter 2 inhibitors
  • SPIRONOLACTONE
  • OUTCOMES

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