Abstract | BACKGROUND: METHODS: RESULTS: Of the 3730 study participants enrolled, 1324 (35.5%) had no vascular disease, 1879 (50.4%) had monovascular disease, and 527 (14.1%) had polyvascular disease. Participants with polyvascular disease tended to be older and male and to have had histories of hypertension, diabetes and smoking. In the placebo arm, a significantly higher risk for cardiovascular death existed in those with polyvascular disease (HR 1.57, 95% CI1.02, 2.44, compared to those with no vascular disease). In adjusted analysis, the benefit of empagliflozin in cardiovascular death or hospitalization due to HF, HF hospitalization, cardiovascular death, renal composite endpoint, estimated glomerular filtration slope changes, and health status scores were seen across the 3 groups (interaction P > 0.05 for all) but were attenuated in those with polyvascular disease. Adverse events were higher in those with polyvascular disease, but no major differences were noted between empagliflozin or placebo assignment in the 3 groups. CONCLUSION: In patients with HFrEF, the extent of vascular disease is associated with the risk for adverse cardiovascular outcomes. Empagliflozin offers cardiovascular and renal benefits in HFrEF across the extent of vascular disease, but this benefit is attenuated in those with polyvascular disease.
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Authors | Muhammad Shahzeb Khan, Stefan D Anker, Gerasimos Filippatos, João Pedro Ferreira, Stuart J Pocock, James L Januzzi, Vijay K Chopra, Ileana L Piña, Michael Böhm, Piotr Ponikowski, Subodh Verma, Martina Brueckmann, Ola Vedin, Barbara Peil, Faiez Zannad, Milton Packer, Javed Butler |
Journal | Journal of cardiac failure
(J Card Fail)
Vol. 29
Issue 10
Pg. 1345-1354
(Oct 2023)
ISSN: 1532-8414 [Electronic] United States |
PMID | 37558088
(Publication Type: Journal Article)
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Copyright | Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved. |