Empagliflozin may be an effective treatment for reducing cardiovascular death and hospitalization for heart failure (HF) across three phenotypes of type 2 diabetes (T2D) patients with varying cardiovascular risk, according to a study published July 26 in JACC: Heart Failure.

Abhinav Sharma, MD, PhD, et al., conducted a post-hoc analysis of the EMPA-REG OUTCOME trial, and used latent class analysis to identify three phenotypes among 7,020 participants with T2D. Each participant received either 25 mg of empagliflozin, 10 mg of empagliflozin, or a placebo. The phenotype groups were determined based on the participants' risk of cardiovascular death or hospitalization for HF.

Results showed that in the first phenotype group, patients were younger, had a shorter T2D duration, and had the highest estimated glomerular filtration rate (eGFR). The second phenotype group included a higher proportion of women with noncoronary artery disease, while the third phenotype group featured older patients with the lowest eGFR and advanced coronary disease.

The risk of cardiovascular death varied across phenotypes with similar patterns for cardiovascular death or hospitalization for HF. According to the authors, "consistent treatment effects of empagliflozin were seen across phenotypes in the training and validation sets."

"Our analysis identified that empagliflozin, compared to placebo, consistently reduced the risk of [cardiovascular] death or [hospitalization for HF] and [cardiovascular] death across phenotype groups," the authors conclude. They add that moving forward, "the pathophysiological mechanisms leading to the development of these distinct phenotypes warrant further evaluation."

View the full lineup from the JACC: Heart Failure special issue on heart failure and diabetes.

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Diabetes Mellitus, Type 2, Glomerular Filtration Rate, Cardiovascular Diseases, Glucosides, Benzhydryl Compounds, Heart Failure, Hospitalization, Coronary Disease, Phenotype, Arteries

< Back to Listings