Evidence map›Paper›PMID 36254693›Full record

Trial reportEuropean heart journal2023

Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial.

Jan Biegus, Adriaan A Voors, Sean P Collins, Mikhail N Kosiborod, John R Teerlink, Christiane E Angermann, Jasper Tromp, Joao Pedro Ferreira, Michael E Nassif, Mitchell A Psotka and 4 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 114 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
114citing papers in PubMed, 8 pooled it
25.9field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

114 citing papers in PubMed, 8 syntheses or guidelines pooled it, 201 citations in OpenAlex.

  1. Pooled it
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  6. Role of dietary sodium restriction in chronic heart failure: systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
    Pooled it
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54 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 12 institutions in 9 countries.

Jan BiegusInstitute of Heart Diseases, Wroclaw Medical University, ul. Borowska 213, Wroclaw 50-556, Poland.ORCID 0000-0001-9977-7722
Adriaan A VoorsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O Box 30001, 9700 RB Groningen, HPC AB 31, The Netherlands.
Sean P CollinsDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Mikhail N KosiborodSaint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA.
John R TeerlinkSection of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco, 4150 Clement Street San Francisco, CA 94121, USA.ORCID 0000-0001-9527-0852
Christiane E AngermannComprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, and Department of Medicine 1, University Hospital Würzburg, Am Schwarzenberg 15, Haus A15 97078 Würzburg, Germany.ORCID 0000-0001-7491-7637
Jasper TrompSaw Swee Hock School of Public Health, National University of Singapore, the National University Health System, Singapore; 12 Science Drive 2, #10-01, Singapore 117549.ORCID 0000-0001-6043-0713
Joao Pedro FerreiraUniversité de Lorraine, Inserm, Centre d'Investigations Cliniques Plurithématique 1433, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.
Michael E NassifSaint Luke's Mid America Heart Institute and the University of Missouri, Kansas City, MO, USA.
Mitchell A PsotkaInova Heart and Vascular Institute, Falls Church, VA, 3300 Gallows Road Falls Church, Virginia 22042, USA.ORCID 0000-0001-7571-9886
Martina BrueckmannBoehringer Ingelheim International GmbH, Binger Straße 173, 55216 Ingelheim am Rhein, Germany.ORCID 0000-0003-1215-0746
Afshin SalsaliNovo Nordisk pharmaceutical company, Vandtårnsvej 110, 2860 Søborg, Copenhagen, Denmark.ORCID 0000-0003-2763-0486
Jonathan P BlatchfordElderbrook Solutions GmbH, Sky Tower, Borsigstr. 4, D-74321 Bietigheim-Bissingen, Germany.ORCID 0000-0001-9354-9657
Piotr PonikowskiInstitute of Heart Diseases, Wroclaw Medical University, ul. Borowska 213, Wroclaw 50-556, Poland.ORCID 0000-0002-3391-7064
Wroclaw Medical University · PLAlaska Heart and Vascular Institute · USBoehringer Ingelheim (Germany) · DEInserm · FRNational University of Singapore · SGRutgers, The State University of New Jersey · USSaint Luke's Hospital · USSan Francisco VA Medical Center · USThe University of Sydney · AUUniversitätsklinikum Würzburg · DEUniversity Medical Center Groningen · NLVanderbilt University Medical Center · US

Funding

Boehringer IngelheimBoehringer Ingelheim and Eli LillyEli Lilly
6 · The paper itself

Abstract

aimsEffective and safe decongestion remains a major goal for optimal management of patients with acute heart failure (AHF). The effects of the sodium-glucose cotransporter 2 inhibitor empagliflozin on decongestion-related endpoints in the EMPULSE trial (NCT0415775) were evaluated. METHODS AND

resultsA total of 530 patients hospitalized for AHF were randomized 1:1 to either empagliflozin 10 mg once daily or placebo for 90 days. The outcomes investigated were: weight loss (WL), WL adjusted for mean daily loop diuretic dose (WL-adjusted), area under the curve of change from baseline in N-terminal pro-B-type natriuretic peptide levels, hemoconcentration, and clinical congestion score after 15, 30, and 90 days of treatment. Compared with placebo, patients treated with empagliflozin demonstrated significantly greater reductions in all studied markers of decongestion at all time-points, adjusted mean differences (95% confidence interval) at Days 15, 30, and 90 were: for WL -1.97 (-2.86, -1.08), -1.74 (-2.73, -0.74); -1.53 (-2.75, -0.31) kg; for WL-adjusted: -2.31 (-3.77, -0.85), -2.79 (-5.03, -0.54), -3.18 (-6.08, -0.28) kg/40 mg furosemide i.v. or equivalent; respectively (all P < 0.05). Greater WL at Day 15 (i.e. above the median WL in the entire population) was associated with significantly higher probability for clinical benefit at Day 90 (hierarchical composite of all-cause death, heart failure events, and a 5-point or greater difference in Kansas City Cardiomyopathy Questionnaire total symptom score change from baseline to 90 days) with the win ratio of 1.75 (95% confidence interval 1.37, 2.23; P < 0.0001).

conclusionInitiation of empagliflozin in patients hospitalized for AHF resulted in an early, effective and sustained decongestion which was associated with clinical benefit at Day 90.

Indexed as

Heart FailureBenzhydryl CompoundsFurosemideGlucosidesHumansBenzhydryl CompoundsempagliflozinFurosemideGlucosidesAcute heart failureDecongestionEmpagliflozinSGLT-2 inhibitor

Identifiers

PMID36254693
PMCPMC9805406
OpenAlexW4306684314

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.