Empagliflozin in Heart Failure with a Preserved Ejection Fraction
Empagliflozin in Heart Failure with a Preserved Ejection Fraction
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DOI：
10.1056/nejmoa2107038
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发表时间：
2021-08-27
影响因子：
158.5
通讯作者：
Packer, Milton
中科院分区：
文献类型：
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作者：
Anker, Stefan D.;Butler, Javed;Packer, Milton
背景：钠-葡萄糖共转运蛋白2抑制剂可降低心力衰竭和射血分数降低患者因心力衰竭住院的风险，但其对心力衰竭和射血分数保持不变的患者的影响尚不确定。方法：在这项双盲试验中，我们随机分配5988例II-IV级心力衰竭和射血分数超过40%的患者，在常规治疗的基础上接受恩格列净（10mg，每日一次）或安慰剂治疗。主要结局是心血管死亡或因心力衰竭住院。结果在26.2个月的中位时间里，恩格列净组2997例患者中有415例（13.8%）发生了主要结局事件，安慰剂组2991例患者中有511例（17.1%）发生了主要结局事件(风险比0.79；95%可信区间[CI]， 0.69 ~ 0.90
BACKGROUNDSodium-glucose cotransporter 2 inhibitors reduce the risk of hospitalization for heart failure in patients with heart failure and a reduced ejection fraction, but their effects in patients with heart failure and a preserved ejection fraction are uncertain.METHODSIn this double-blind trial, we randomly assigned 5988 patients with class II-IV heart failure and an ejection fraction of more than 40% to receive empagliflozin (10 mg once daily) or placebo, in addition to usual therapy. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure.RESULTSOver a median of 26.2 months, a primary outcome event occurred in 415 of 2997 patients (13.8%) in the empagliflozin group and in 511 of 2991 patients (17.1%) in the placebo group (hazard ratio, 0.79; 95% confidence interval [CI], 0.69 to 0.90; P