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Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure
Open accessAbstract
BACKGROUNDSodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure in patients regardless of the presence or absence of diabetes.More evidence is needed regarding the effects of these drugs in patients across the broad spectrum of heart failure, including those with a markedly reduced ejection fraction. METHODSIn this double-blind trial, we randomly assigned 3730 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less to receive empagliflozin (10 mg once daily) or placebo, in addition to recommended therapy.The primary outcome was a composite of cardiovascular death or hospitalization for worsening heart failure. RESULTSDuring a median of 16 months, a primary outcome event occurred in 361 of 1863 patients (19.4%) in the empagliflozin group and in 462 of 1867 patients (24.7%) in the placebo group (hazard ratio for cardiovascular death or hospitalization for heart failure, 0.75; 95% confidence interval [CI], 0.65 to 0.86; P<0.001).The effect of empagliflozin on the primary outcome was consistent in patients regardless of the presence or absence of diabetes.The total number of hospitalizations for heart failure was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.70; 95% CI, 0.58 to 0.85; P<0.001).The annual rate of decline in the estimated glomerular filtration rate was slower in the empagliflozin group than in the placebo group (-0.55 vs. -2.28ml per minute per 1.73 m 2 of body-surface area per year, P<0.001), and empagliflozin-treated patients had a lower risk of serious renal outcomes.Uncomplicated genital tract infection was reported more frequently with empagliflozin. CONCLUSIONSAmong patients receiving recommended therapy for heart failure, those in the empagliflozin group had a lower risk of cardiovascular death or hospitalization for heart failure than those in the placebo group, regardless of the presence or absence of diabetes.(Funded by Boehringer Ingelheim and Eli Lilly; EMPEROR-Reduced ClinicalTrials.govnumber, NCT03057977.
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In the citing paper
“Subgroup analyses from DAPA-CKD (117) and analyses from the EMPEROR heart failure trials suggest that SGLT2 inhibitors are safe and effective at eGFR levels of >20 mL/min/1.73m 2 .”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [119]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Direct evidence is provided by the DAPA-CKD, SCORED, EMPEROR-Reduced, and EMPEROR-Preserved trials, which enrolled such participants by design.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, notably, SGLT2i have been studied among patients without T2D who have CKD in the DAPA-CKD trial (and the soonto-be-published EMPA-KIDNEY trial) or who have heart failure (in the DAPA-HF, EMPEROR-Reduced, and EMPEROR-Preserved trials) and did not confer any increased risk of severe hypoglycemia or diabetic ketoacidosis among individuals without T2D.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“enrollment criteria included eGFR >60 mL/min/1.73m 2 , but efficacy was seen at eGFR >20 mL/min/1.73m 2 in people with heart failure.”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [135]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“SGLT2 inhibitors reduce the incidence of heart failure and improve heart failurerelated outcomes, including hospitalization for heart failure and heart failure-related symptoms, in people with diabetes with preserved or reduced ejection fraction (250,(255)(256)(257)(298)(299)(300)(301)(302)(303)(304)(305)(306).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [303]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“and the Empagliflozin Outcome Trial in Patients With Chronic Heart Failure (EMPEROR) trials (which provided clear evidence of efficacy and safety for empagliflozin among patients with eGFR ≥20 mL/min/1.73 m2 and HF) (54,57,58).”
From Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (2022) · cites this paper as [58]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Clinical trials, such as EMPEROR-REDUCED (empagliflozin) and DAPA-CKD (dapagliflozin), have shown that SGLT-2 inhibitors have benefits in patients with heart failure and chronic kidney disease, regardless of the presence of diabetes.38,39”
From Tirzepatide: Clinical review of the twincretin injectable (2023) · cites this paper as [39]
The cited source says what the claim attributes to it.
In the citing paper
“The primary outcome among those with an eGFR $ 60 ml/min per 1.73 m 2 was HR: 0.67; 95% CI: 0.55 -0.83 and for those with eGFR < 60 ml/min per 1.73 m 2 was HR: 0.83; 95% CI: 0.69 -1.00.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
The cited source says what the claim attributes to it.
In the citing paper
“As seen in DAPA-HF, the primary outcome was similarly reduced for individuals with and without diabetes.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
The cited source says what the claim attributes to it.
In the citing paper
“the primary outcome of cardiovascular death or heart failure hospitalization occurred in 19.4% of the empagli fl ozin group and 24.7% of the placebo group (HR: 0.75; 95% CI: 0.65 -0.86).”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
The cited source says what the claim attributes to it.
In the citing paper
“A composite kidney outcome HR of 0.50 (95% CI: 0.32 -0.77) was also reported.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
The cited source says what the claim attributes to it.
In the citing paper
“Similar results were obtained in clinical trials with empagliflozin (303).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [303]
The cited source says what the claim attributes to it.
In the citing paper
“Similar results were obtained in clinical trials with empagliflozin (291).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [291]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The EMPEROR-Reduced 101 and EMPEROR-Preserved 102 trials, although not an exclusive CKD population, did allow enrollment of patients with an eGFR as low as 20 ml/min per 1.73 m 2.”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The EMPA-REG trial enrolled over 7000 patients with T2D, baseline glycated hemoglobin (HbA1c) of 7% -10%, established CVD (almost 100%), and an eGFR of at least 30 ml/min per 1.73 m 2 . 101”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The EMPEROR-Reduced and EMPEROR-Preserved trials, although not exclusive CKD populations, did allow enrollment participants with an eGFR as low as 20 ml/min per 1.73 m 2 .”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [101]
Experimental — accuracy not yet measuredIn the citing paper
“The EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction) trial demonstrated a benefit of SGLT2 inhibition with empagliflozin to reduce both the risk and rate of heart failure hospitalizations.7”
From Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial (2021) · cites this paper as [7]
In the citing paper
“Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown to reduce the risk of hospitalizations for heart failure in 8 large-scale trials, including those that focused on type 2 diabetes, heart failure with a reduced ejection fraction, and chronic kidney disease.1–8”
From Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial (2021) · cites this paper as [7]
In the citing paper
“As previously reported,7 the 2 groups comprised patients with mild, moderate, and severe heart failure, as reflected by left ventricular ejection fraction and circulating levels of NT-proBNP, and were well-balanced with respect to baseline characteristics.”
From Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial (2021) · cites this paper as [7]
In the citing paper
“In the EMPEROR-Reduced trial, empagliflozin reduced the risk of cardiovascular death or hospitalization for heart failure, a benefit that was driven primarily by an effect of the drug to reduce first and recurrent admissions for worsening heart failure.7”
From Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial (2021) · cites this paper as [7]
In the citing paper
“In our original publication and in a meta-analysis of the DAPA-HF and EMPEROR-Reduced trials, we noted a somewhat lesser benefit in patients with ejection fraction of 31% to 40% and in patients with class III symptoms.”
From Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial (2021) · cites this paper as [7]
In the citing paper
“Rates of worsening heart failure or cardiovascular death are lower among patients with heart failure who are treated with dapagliflozin and empagliflozin regardless of diabetes diagnosis.7,8”
From Association of race/ethnicity, gender, and socioeconomic status with sodium-glucose cotransporter 2 inhibitor use among patients with diabetes in the US (2021) · cites this paper as [8]
In the citing paper
“As for the morbidity, renal outcome and HHF, it was clear that SGLT-2i had more significant impact than finerenone, which might be explained by the special potency of SGLT-2i such as reducing blood glucose, reducing oxidative stress, losing weight, reducing uric acid, controlling blood pressure and improving renal ultrafiltration and hypoxia [65, 71–79].”
In the citing paper
“Multiple SGLT2i trials included subsets of participants without diabetes, who appear to have derived similar benefits as those with T2D, 8,14,18”
In the citing paper
“Treatment with empagliflozin improved quality of life.496”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [496]
In the citing paper
“The risk of a prespeci fi ed renal composite outcome (chronic dialysis, renal transplantation, or a sustained reduction in eGFR) was lower in the empagli fl ozin group than in the placebo group (1.6% in the empaglifl ozin group vs. 3.1% in the placebo group; HR 0.50 [95% CI 0.32 -0.77]).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2023 (2023) · cites this paper as [200]
In the citing paper
“Over a median follow-up of 16 months, those in the empagli fl ozin-treated group had a reduced risk of the primary outcome (HR 0.75 [95% CI 0.65 -0.86]; P < 0.001) and fewer total hospitalizations for heart failure (HR 0.70 [95% CI 0.58 -0.85]; P < 0.001).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2023 (2023) · cites this paper as [200]
In the citing paper
“Over a median follow-up of 16 months, those in the empagli fl ozin-treated group had a reduced risk of the primary outcome (HR 0.75 [95% CI 0.65 -0.86]; P < 0.001) and fewer total hospitalizations for heart failure (HR 0.70 [95% CI 0.58 -0.85]; P < 0.001).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2023 (2023) · cites this paper as [200]
In the citing paper
“The effect of empagli fl ozin on the primary outcome was consistent irrespective of diabetes diagnosis at baseline.”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2023 (2023) · cites this paper as [200]
In the citing paper
“Moreover, in the recent EMPEROR-Reduced trial (Empagliflozin Outcome Trial in Patients with Chronic Heart Failure and a Reduced Ejection Fraction), SGLT2 inhibition did reduce renal events significantly, although that trial used a different renal composite outcome and had more renal events than in DAPA-HF (88 versus 67).”
From Efficacy of Dapagliflozin on Renal Function and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction: Results of DAPA-HF (2021) · cites this paper as [21]
In the citing paper
“More recently, in a large trial using empagliflozin in patients with HFrEF, the rate of decline in eGFR was 2.28 (SD 0.23) mL·min–1·1.73 m–2 per year, which was reduced to 0.55 (0.23) in the SGLT2 inhibitor group.21”
From Efficacy of Dapagliflozin on Renal Function and Outcomes in Patients With Heart Failure With Reduced Ejection Fraction: Results of DAPA-HF (2021) · cites this paper as [21]
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Background2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
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“The effect of empagliflozin was evident regardless of the presence of diabetes [74].”
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BackgroundCurrent and future therapeutic perspective in chronic heart failure
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Self-citationEmpagliflozin and major renal outcomes in heart failure
Packer, M., Butler, J., Zannad, F., Pocock, S. J., Filippatos, G., Ferreira, J. P., Brueckmann, M., Jamal, W., Zeller, C., Wanner, C., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmc2112411 · Cited by 112
Self-citationDesign, recruitment, and baseline characteristics of the EMPA-KIDNEY trial
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“EMPA-REG OUTCOME data also raised the hypothesis—which has recently been confirmed in the EMPEROR trials [20, 21]—that empagliflozin has the potential to prevent or treat the particular types of heart disease experienced by people with CKD [8, 9, 14, 15, 35].”
Self-citationImpact of SGLT2 Inhibitors on Heart Failure: From Pathophysiology to Clinical Effects
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“The DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) study was instead the first international, multicenter, parallel-group, randomized, doubleblind clinical trial on a SGLT2i designed to assess the effect of Dapagliflozin 10 mg (oncedaily, in addition to the standard care) vs. a placebo in…”
BackgroundInfluentialLaffel, L. M., Danne, T., KLINGENSMITH, G. J., Tamborlane, W. V., Willi, S. M., Zeitler, P. S., Neubacher, D., Marquard, J., Bardymova, T. P., Pérez, M. B., et al. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00387-4 · Cited by 122
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The win ratio in cardiology trials: lessons learnt, new developments, and wise future use
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“6,19 For each trial, we converted the original primary endpoint into a hierarchical composite of time to CV death and time to first HF hospitalization.”
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Management of Heart Failure Patient with CKD
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Cardiovascular protection by SGLT2 inhibitors – Do anti-inflammatory mechanisms play a role?
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“T support the glucose-independent mechanisms of SGLT2 inhibitors [19,20,23].”
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“EMPEROR-R compared empagliflozin to placebo in 3730 patients with or without T2D and heart failure with reduced ejection fraction [21].”
MethodAvula, V. R., Sharma, G. V., Kosiborod, M., Vaduganathan, M., Neilan, T. G., López‐Fernández, T., Dent, S. F., Baldassarre, L. A., Scherrer‐Crosbie, M., Barac, A., et al. (2023) · JACC Heart Failure · doi:10.1016/j.jchf.2023.08.026 · Cited by 113
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11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s011 · Cited by 108
SGLT2 inhibitors for non-diabetic kidney disease: drugs to treat CKD that also improve glycaemia
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“The EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction (EMPEROR-Reduced) trial tested empagliflozin in patients with HF [15], while the Study to Evaluate the Effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients With Chronic Kidney Disease (DA…”
BackgroundMethodInfluentialMuthiah, M. D., Han, N. C., & Sanyal, A. J. (2021) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14521 · Cited by 111
“Patients with NAFLD may mani- fest with a reduced estimated glomerular filtration rate, or the presence of albuminuria.59–61 These appear to correlate positively with the presence of NASH as well as the severity of liver fibrosis, and improvements in liver histology were associated with an improvement in the CKD.62,63…”
BackgroundPrognostic Importance of NT-proBNP and Effect of Empagliflozin in the EMPEROR-Reduced Trial
Januzzi, J. L., Zannad, F. M., Anker, S. D., Butler, J., Filippatos, G. S., Pocock, S., Ferreira, J. P., Sattar, N. A., Verma, S., Vedin, O., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.07.046 · Cited by 108
Self-citation10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s010 · Cited by 107
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Relationship of Nonalcoholic Fatty Liver Disease and Heart Failure With Preserved Ejection Fraction
Salah, H. M., Pandey, A., Soloveva, A. E., Abdelmalek, M. F., Diehl, A. M., Moylan, C. A., Wegermann, K., Rao, V. N., Hernandez, A. F., Tedford, R. J., et al. (2021) · JACC Basic to Translational Science · doi:10.1016/j.jacbts.2021.07.010 · Cited by 110
“Obesity is a major risk factor for metabolic syndrome and HF (both HFrEF and HFpEF).”
BackgroundInfluentialSodium Glucose Cotransporter-2 Inhibition for Acute Myocardial Infarction
Udell, J. A., Jones, W. S., Petrie, M. C., Harrington, J., Anker, S. D., Bhatt, D. L., Hernandez, A. F., & Butler, J. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.03.353 · Cited by 110
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Self-citationEffect of Empagliflozin on Hemodynamics in Patients With Heart Failure and Reduced Ejection Fraction
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Defects in the Proteome and Metabolome in Human Hypertrophic Cardiomyopathy
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Applications of SGLT2 inhibitors beyond glycaemic control
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“Both studies showed that treatment with an SGLT2 inhibitor added to usual care achieved all three key goals of therapy — reduced heart failure hospitalization or urgent visits for heart failure, reduced cardiovascular death and improved symptom burden 65,66 .”
InfluentialType 2 Diabetes and Myocardial Infarction: Recent Clinical Evidence and Perspective
Cui, J., Liu, Y., Li, Y. H., Xu, F., & Liu, Y. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.644189 · Cited by 112
eGFR Decline after SGLT2 Inhibitor Initiation: The Tortoise and the Hare Reimagined
Meraz-Muñoz, A., Weinstein, J. J., & Wald, R. (2021) · Kidney360 · doi:10.34067/kid.0001172021 · Cited by 111
“73m(2)) shortly after initiating these drugs compared to placebo controls (5,8,9,11,12).”
BackgroundThe Combination of Beta-Blockers and ACE Inhibitors Across the Spectrum of Cardiovascular Diseases
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“NT-proBNP, pg/mL 1,104 (668, 2,424) 1,136 (551, 2,026) 0.”
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“Conclusion: Use of SGLT2 inhibitors versus GLP-1 RAs was associated with consistent reductions in HHF risk among T2D patients with and without CVD, although the absolute benefit was greater in patients with CVD.”
BackgroundInfluentialTheofilis, P., Sagris, Μ., Oikonomou, E. K., Antonopoulos, A. S., Siasos, G., Tsioufis, K. P., & Tousoulis, D. (2022) · International Immunopharmacology · doi:10.1016/j.intimp.2022.109080 · Cited by 108
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Self-citationDeranged Myocardial Fatty Acid Metabolism in Heart Failure
Yamamoto, T., & Sano, M. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23020996 · Cited by 107
Update on Diabetic Kidney Disease (DKD): Focus on Non-Albuminuric DKD and Cardiovascular Risk
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“Additionally, in the Empagliflozin Outcome Trial in Patients With Chronic Heart Failure and a Reduced Ejection Fraction (EMPEROR-Reduced) trial [96], the rate of decline of eGFR over the duration of the treatment period was slower in the empagliflozin group than in the placebo group, with a significant difference of 1.”
Glucose-Lowering Drugs to Reduce Cardiovascular Risk in Type 2 Diabetes
Kalyani, R. R. (2021) · New England Journal of Medicine · doi:10.1056/nejmcp2000280 · Cited by 101
Molecular Mechanisms of SGLT2 Inhibitor on Cardiorenal Protection
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“In other studies for empagliflozin, a lowered risk of CV death and HHF was also shown in the EMPA-REG OUTCOME trial in people with T2D and a history of CVD [126] and in the EMPEROR-Reduced trial in people with HFrEF regardless of the presence of diabetes [127].”
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Cheong, A. J. Y., Teo, Y. N., Teo, Y. H., Syn, N. L. X., Ong, H. T., Ting, A. Z. H., Chia, A. Z. Q., Chong, E. Y., Chan, M. Y., Lee, C., et al. (2021) · Obesity · doi:10.1002/oby.23331 · Cited by 107
Accelerated and personalized therapy for heart failure with reduced ejection fraction
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“The most effective alternative sequences were those starting either with an SGLT2i or an MRA, reflecting the fact that the former treatment is administered in a single fixed dose and the latter has a maximum of two dose steps.(4,5,11) The slight differences between the various sequences tested, for the two outcomes ex…”
Self-citationDigitoxin in Patients with Heart Failure and Reduced Ejection Fraction
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Self-citationMyocardial ketone body utilization in patients with heart failure: The impact of oral ketone ester
Monzo, L., Sedláček, K., Hromaníková, K., Tomanova, L., Borlaug, B. A., Jabor, A., Kautzner, J., & Melenovský, V. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154452 · Cited by 99
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Cunningham, J. W., Vaduganathan, M., Claggett, B. L., Kulac, I. J., Desai, A. S., Jhund, P. S., de Boer, R. A., DeMets, D. L., Hernandez, A. F., Inzucchi, S. E., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.07.021 · Cited by 108
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2024 EACTS Guidelines on perioperative medication in adult cardiac surgery
Jeppsson, A., (Sweden), (.-C., Rocca, B., (Italy), (.-C., Hansson, E. C., (Sweden), Guðbjartsson, T., (Iceland), James, S. K., (Sweden), et al. (2024) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezae355 · Cited by 114
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SGLT2-inhibitors; more than just glycosuria and diuresis
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Self-citationEffects of Sodium-Glucose Cotransporter 2 Inhibitors on Water and Sodium Metabolism
Tang, J., Ye, L., Yan, Q., Zhang, X., & Wang, L. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.800490 · Cited by 106
2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure: Executive Summary
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Pharmacological approaches to the prevention of type 2 diabetes mellitus
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“07) and EMPEROR-Reduced study (47) (HR: 0.”
Current Treatments for Diabetic Macular Edema
Tatsumi, T. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24119591 · Cited by 107
“Not only does SGLT2i have therapeutic effects on diabetes by lowering blood glucose, but it also has been shown to have protective effects on the heart [170] and kidneys [171].”
BackgroundLin, D. S.-H., Lee, J.-K., & Chen, W.-J. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab274 · Cited by 97
SGLT2 inhibitors: the statins of the 21st century
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SGLT2 Inhibitors and Ketone Metabolism in Heart Failure
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Signaling cascades in the failing heart and emerging therapeutic strategies
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Genetics of myocardial interstitial fibrosis in the human heart and association with disease
Nauffal, V., Achille, P. D., Klarqvist, M. D. R., Cunningham, J. W., Hill, M. C., Pirruccello, J. P., Weng, L.-C. C., Morrill, V. N., Choi, S. H., Khurshid, S. S., et al. (2023) · Nature Genetics · doi:10.1038/s41588-023-01371-5 · Cited by 96
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Self-citationChallenges in developing Geroscience trials
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“SGTL-2 inhibitors Packer et al.(78) A composite of cardiovascular death or hospitalization for worsening heart failure.”
BackgroundCardiorenal diseases in type 2 diabetes mellitus: clinical trials and real-world practice
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Optimizing Foundational Therapies in Patients With HFrEF
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Self-citationNew strategies to improve clinical outcomes for diabetic kidney disease
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“Composite kidney disease outcomes were somewhat similar between studies (e.g., composite of sustained decrease in eGFR of 40% or more, to less than 60 mL/min/1.73 m2, incident ESKD, death from kidney or cardiovascular disease causes in DECLARE-TIMI 58 and incident chronic dialysis or transport protein 2; RAS, renin-an…”
BackgroundInfluentialCardioprotective Glucose-Lowering Agents and Dementia Risk: A Systematic Review and Meta-Analysis
Seminer, A., Mulihano, A., O’Brien, C., Krewer, F., Costello, M., Judge, C., O’Donnell, M., & Reddin, C. (2025) · JAMA Neurology · doi:10.1001/jamaneurol.2025.0360 · Cited by 91
Empagliflozin and serum potassium in heart failure: an analysis from EMPEROR-Pooled
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“AFib, atrial fibrillation; ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor-neprilysin inhibitor; BMI, body mass index; CCB, calcium channel blocker; CRT, cardiac resynchronization therapy; CRT-D, cardiac resynchronization therapy with a defibrillator; CRT-P,…”
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Prevalence, outcomes and costs of a contemporary, multinational population with heart failure
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Metadata
- Authors
- Packer, M., Anker, S. D., Butler, J., Filippatos, G., Pocock, S. J., Carson, P., Januzzi, J., Verma, S., Tsutsui, H., Brueckmann, M., Jamal, W., Kimura, K., Schnee, J., Zeller, C., Cotton, D., Bocchi, E., Böhm, M., Choi, D.-J., Chopra, V., Chuquiure, E., Giannetti, N., Janssens, S., Zhang, J., Gonzalez Juanatey, J. R., Kaul, S., Brunner-La Rocca, H.-P., Merkely, B., Nicholls, S. J., Perrone, S., Pina, I., Ponikowski, P., Sattar, N., Senni, M., Seronde, M.-F., Spinar, J., Squire, I., Taddei, S., Wanner, C., & Zannad, F.
- Affiliations
- University of Leicester (GB)
- Harvard University (US)
- St. Michael's Hospital (CA)
- Kyushu University (JP)
- Boehringer Ingelheim (Germany) (DE)
- Seoul National University (KR)
- From Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas (M.P.); Imperial College (M.P.) and the Department of Medical Statistics, London School of Hygiene and Tropical Medicine (S.J.P.), London, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow (N.S.), and the Department of Cardiovascular Sciences, University of Leicester and National Institute for Health Research Biomedical Research Centre, Glenfield Hospital, Leicester (I.S.) — all in the United...
- Cedars-Sinai Medical Center (US)
- University of Pisa (IT)
- ORCID
- Packer, Milton
- Anker, Stefan D.
- Butler, Javed
- Filippatos, Gerasimos
- Pocock, Stuart J.
- Januzzi, James
- Verma, Subodh
- Tsutsui, Hiroyuki
- Brueckmann, Martina
- Jamal, Waheed
- Kimura, Karen
- Schnee, Janet
- Zeller, Cordula
- Cotton, Daniel
- Bocchi, Edimar
- Böhm, Michael
- Choi, Dong-Ju
- Chopra, Vijay
- Giannetti, Nadia
- Janssens, Stefan
- Zhang, Jian
- Kaul, Sanjay
- Nicholls, Stephen J.
- Perrone, Sergio
- Ponikowski, Piotr
- Sattar, Naveed
- Senni, Michele
- Seronde, Marie-France
- Squire, Iain
- Taddei, Stefano
- Wanner, Christoph
- Zannad, Faiez
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-10-08
- Volume
- 383
- Issue
- 15
- Pages
- 1413-1424
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W3081830235
- Semantic Scholar
- 9f762448aff37cda38166e57ac40bc13f0005f51
- Cited by
- 5,206
- References
- 10
- Citations by year
- 2026: 638 · 2025: 757 · 2024: 820 · 2023: 965 · 2022: 936 · 2021: 910 · 2020: 163
- FWCI
- 459.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- HAL (submittedVersion, other-oa)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Figshare (submittedVersion, cc-by)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Lirias (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- Boehringer Ingelheim
- Eli Lilly
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- empagliflozin, SGLT2 inhibitors, heart failure with reduced ejection fraction, cardiovascular mortality, hospitalization for worsening heart failure, renal outcomes, estimated glomerular filtration rate decline, genital tract infection, diabetes status, EMPEROR-Reduced trial
- MeSH terms
- Sodium-Glucose Transporter 2 Inhibitors, Aged, Benzhydryl Compounds, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Double-Blind Method, Female, Glomerular Filtration Rate, Glucosides, Heart Failure, Hospitalization, Humans, Male, Middle Aged, Stroke Volume, Proportional Hazards Models, Disease Progression, Renal Insufficiency, Chronic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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