Evidence map›Paper›PMID 33175585›Full record

ArticleCirculation2021

Effect of Empagliflozin on Cardiovascular and Renal Outcomes in Patients With Heart Failure by Baseline Diabetes Status: Results From the EMPEROR-Reduced Trial.

Stefan D Anker, Javed Butler, Gerasimos Filippatos, Muhammad Shahzeb Khan, Nikolaus Marx, Carolyn S P Lam, Sven Schnaidt, Anne Pernille Ofstad, Martina Brueckmann, Waheed Jamal and 10 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03057977. Cited by 171 papers, 27 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
171citing papers in PubMed, 27 pooled it
32.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03057977 phase3completed

A Phase III Randomised, Double-blind Trial to Evaluate Efficacy and Safety of Once Daily Empagliflozin 10 mg Compared to Placebo, in Patients With Chronic Heart Failure With Reduced Ejection Fraction (HFrEF)

Ran2017Enrolled3,730Registered outcomes10Posted comparisons10ConditionsHeart FailureArmsempagliflozin, Placebo
Open the trial in the graph
3 · Its place in the literature

Who cites it

171 citing papers in PubMed, 27 syntheses or guidelines pooled it, 342 citations in OpenAlex.

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  20. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline

111 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 17 institutions in 13 countries.

Stefan D AnkerDepartment of Cardiology, Berlin Institute of Health Center for Regenerative Therapies, German Centre for Cardiovascular Research partner site Berlin, Charité Universitätsmedizin Berlin, Germany (S.D.A.).
Javed ButlerDepartment of Medicine, University of Mississippi School of Medicine, Jackson (J.B., M.S.K.).
Gerasimos FilippatosNational and Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon, Greece (G.F.).
Muhammad Shahzeb KhanDepartment of Medicine, University of Mississippi School of Medicine, Jackson (J.B., M.S.K.).
Nikolaus MarxDepartment of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Germany (N.M.).
Carolyn S P LamNational Heart Centre Singapore & Duke-National University of Singapore (C.S.P.L.).
Sven SchnaidtBoehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany (S.S.).
Anne Pernille OfstadMedical Department, Boehringer Ingelheim Norway KS, Asker, Norway (A.P.O.).
Martina BrueckmannBoehringer Ingelheim International GmbH, Ingelheim, Germany (M.B., W.J.).
Waheed JamalBoehringer Ingelheim International GmbH, Ingelheim, Germany (M.B., W.J.).
Edimar A BocchiHeart Institute of the University of Sao Paulo (InCor), Brazil (E.A.B.).
Piotr PonikowskiWroclaw Medical University, Poland (P.P.).
Sergio V PerroneHospital de Alta Complejidad El Cruce "Nestor Kirchner," Florencio Varela, Buenos Aires, Argentina (S.V.P.).
James L JanuzziHarvard Medical School, Massachusetts General Hospital, Boston (J.L.J.).
Subodh VermaDivision of Cardiac Surgery, St Michael's Hospital, University of Toronto, Canada (S.V.).
Michael BöhmBoehringer Ingelheim International GmbH, Ingelheim, Germany (M.B., W.J.).
João Pedro FerreiraInstitut Lorrain du Coeur et des Vaisseaux, Nancy, France (J.P.F., F.Z.).
Stuart J PocockDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, UK (S.J.P.).
Faiez ZannadInstitut Lorrain du Coeur et des Vaisseaux, Nancy, France (J.P.F., F.Z.).
Milton PackerBaylor University Medical Center, Dallas, TX (M.P.).
Boehringer Ingelheim (Germany) · DEInstitut des Vaisseaux et du Sang · FRUniversity of Mississippi Medical Center · USBaylor University Medical Center · USBoehringer Ingelheim (Norway) · NOGerman Centre for Cardiovascular Research · DEHarvard University · USHeidelberg University · DEHospital El Cruce · ARNational and Kapodistrian University of Athens · GRNational University of Singapore · SGSt. Michael's Hospital · CAUniversidade de São Paulo · BRUniversitätsklinikum Aachen · DEUniversity of London · GBUniversity of Mannheim · DEWroclaw Medical University · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSodium-glucose cotransporter 2 inhibitors improve outcomes in patients with heart failure with reduced ejection fraction, but additional information is needed about whether glycemic status influences the magnitude of their benefits on heart failure and renal events.

methodsPatients with Class II-IV heart failure and a left ventricular ejection fraction ≤40% were randomized to receive empagliflozin (10 mg daily) or placebo in addition to recommended therapy. We prespecified a comparison of the effect of empagliflozin in patients with and without diabetes.

resultsOf the 3730 patients enrolled, 1856 (50%) had diabetes, 1268 (34%) had prediabetes (hemoglobin A1c [HbA1c] 5.7-6.4%), and 606 (16%) had normoglycemia (HbA1c <5.7%). The risks of the primary outcome (cardiovascular death or hospitalization for heart failure), total hospitalizations for heart failure, and adverse renal outcomes were higher in patients with diabetes, but were similar between patients with prediabetes and normoglycemia. Empagliflozin reduced the risk of the primary outcome in patients with and without diabetes (hazard ratio, 0.72 [95% CI, 0.60-0.87] and 0.78 [95% CI, 0.64-0.97], respectively,

conclusionsIn EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction), empagliflozin significantly improved cardiovascular and renal outcomes in patients with heart failure and a reduced ejection fraction, independent of baseline diabetes status and across the continuum of HbA1c. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03057977.

Indexed as

AgedBenzhydryl CompoundsCardiovascular DiseasesDiabetes Mellitus, Type 2FemaleGlucosidesHeart FailureHumansMaleRenal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsTreatment OutcomeBenzhydryl CompoundsempagliflozinGlucosidesSodium-Glucose Transporter 2 Inhibitorsdiabetes mellitusempagliflozinheart failure

Identifiers

PMID33175585
PMCPMC7834911
OpenAlexW3103126890

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.