ArticleEuropean journal of heart failure2021
Use of diuretics and outcomes in patients with type 2 diabetes: findings from the EMPA-REG OUTCOME trial.
Article in European journal of heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Canagliflozin reduces oral loop diuretic intensification in patients with type 2 diabetes: A participant-level pooled analysis of the CANVAS and CREDENCE trials.European journal of heart failure · 2025Trial
- Post-Hoc Analysis on the Effects of Vicadrostat/Empagliflozin by CKD Severity/Hypertension Status.Kidney international reports · 2026Article
- Association Between Reduction in Loop Diuretics and Heart Failure Rehospitalization After Transcatheter Aortic Valve Replacement.Circulation reports · 2026Article
- Loop Diuretic Therapy in Severe Aortic Stenosis: Marker of Organ Congestion, Unfavorable Hemodynamics, and Increased Post-Valve Replacement Mortality.Clinical cardiology · 2025Article
- Imaging of Congestion in Cardio-renal Syndrome.Current heart failure reports · 2025Review
- Loop diuretic therapy with or without heart failure: impact on prognosis.European heart journal · 2024Article
- SGLT2 Inhibitors - The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024Review
- Empagliflozin in the treatment of heart failure.Future cardiology · 2024Review
- Update on clinical and experimental management of diabetic cardiomyopathy: addressing current and future therapy.Frontiers in endocrinology · 2024Review
- Diuretic dose trajectories in dilated cardiomyopathy: prognostic implications.Clinical research in cardiology : official journal of the German Cardiac Society · 2023Article
- Article
- Defining Heart Failure Based on Imaging the Heart and Beyond.Cardiac failure review · 2023Review
- SGLT2 Inhibitors Improve Cardiac Failure by Reducing Whole-Body Oxygen Demand: A Hypothesis.Clinical drug investigation · 2022Review
- New Strategies for Volume Control in Patients with Diabetes Mellitus, a Narrative Review.Pharmaceutics · 2022Review
- The Place and Value of Sodium-Glucose Cotransporter 2 Inhibitors in the Evolving Treatment Paradigm for Type 2 Diabetes Mellitus: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2022 · on this mapReview
- Sodium-glucose co-transporter 2 inhibitors as an early, first-line therapy in patients with heart failure and reduced ejection fraction.European journal of heart failure · 2022Review
- Optimal Management of Heart Failure and Chronic Obstructive Pulmonary Disease: Clinical Challenges.International journal of general medicine · 2022Review
- Cardiovascular and Renal Outcomes with Ertugliflozin by Baseline Use of Renin-Angiotensin-Aldosterone System Inhibitors or Diuretics, Including Mineralocorticoid Receptor Antagonist: Analyses from the VERTIS CV Trial.Kidney diseases (Basel, Switzerland)Article
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12 authors.
Funding
Abstract
aimsLoop diuretics (LD) relieve symptoms and signs of congestion due to heart failure (HF), but many patients prescribed LD do not have such a diagnosis. We studied the relationship between HF diagnosis, use of LD, and outcomes in patients with type 2 diabetes mellitus (T2DM) enrolled in the EMPA-REG OUTCOME trial. METHODS AND
resultsThe relationship between HF diagnosis, use of LD, and outcomes was evaluated in four patient subgroups with T2DM: (i) investigator-reported HF on LD, (ii) investigator-reported HF not on LD, (iii) no HF on LD, and (iv) no HF and not on LD, and we assessed their risk of cardiovascular events. Of 7020 participants, 706 (10%) had a diagnosis of HF at baseline, of whom 334 were prescribed LD. However, 755 (11%) patients who did not have a diagnosis of HF were prescribed LD. Compared to those with neither HF nor prescribed LD (reference group; placebo), those with both HF and receiving LD had the highest rates for all-cause [hazard ratio (HR) (95% confidence interval) 3.19 (2.03-5.01)] and cardiovascular mortality [3.83 [(2.28-6.44)], and HF hospitalizations [9.51 (5.61-16.14)]. Patients without HF but prescribed LD had higher rates for all three outcomes [1.62 (1.10-2.39); 1.97 (1.26-3.08); 3.20 (1.90-5.39)], which were similar to patients with HF who were not receiving LD [1.42 (0.78-2.57); 1.56 (0.78-3.11); 3.00 (1.40-6.40)]. Empagliflozin had similar benefits regardless of subgroup (P for interaction >0.1 for all outcomes).
conclusionPatients with T2DM prescribed LD are at greater risk of cardiovascular events even if they are not reported to have HF; this might reflect under-diagnosis. Empagliflozin was similarly effective in all subgroups investigated.
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