Abstract 12740: Efficacy and Safety of Empagliflozin in Acute Heart Failure: A Systematic Review and Meta-Analysis
Muhammad Adil Afzal, Muhammad Abdullah, Noman Khalid, Rovena Collins, Taulant Gashi, Mubariz Hassan, Ata Ul Haiy, Sherif Elkattawy, Patrick Michael, Rahul Vasudev, fayez shamoon- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Introduction: Acute heart failure (AHF) significantly burdens healthcare systems, leading to hospitalizations, morbidity, and mortality in older adults. Among patients suffering from chronic heart failure, empagliflozin, which is a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, has shown positive cardiovascular effects. While several studies have investigated SGLT-2 inhibitor use in hospitalized AHF patients, there is a lack of meta-analysis specifically focused on empagliflozin. To ascertain the efficacy and safety of empagliflozin in AHF, the following systematic review plus meta-analysis was conducted.
Methods: We comprehensively searched Cochrane, Clinicaltrials.gov, and MEDLINE databases. After title, abstract, and full-text screening, the data discussing relevant safety and efficacy outcomes of empagliflozin were extracted, and a random-effects meta-analysis odds ratio was calculated. We conducted a sensitivity analysis by removing the post-hoc study.
Results: We retrieved 852 documents after initial database searches, and after the screening, 3 RCTs were included with 824 participants. Empagliflozin significantly reduced the odds of all-cause mortality (OR: 0.47, 95%CI: 0.29-0.78, p=0.004) and cardiovascular death (OR: 0.56, 95%CI: 0.38-0.82, p=0.003) when compared to placebo. Furthermore, empagliflozin demonstrated a lower serious adverse event risk (OR: 0.62, 95% CI: 0.44-0.87, p=0.005) without exacerbating adverse drug effects such as acute kidney injury, diabetic ketoacidosis, hypotension, and urinary tract infections significantly. Sensitivity analysis confirmed these findings.
Conclusion: Our study suggests that empagliflozin holds promise in reducing cardiovascular and all-cause mortality in AHF patients. However, its impact on rehospitalizations remains uncertain. Larger and more diverse clinical trials are warranted to establish further the role of empagliflozin in managing heart failure.