SGLT2 Inhibitor Therapy for High-Risk Patients:

EMPA-KIDNEY trial and Meta-Analysis of Major Trials of SGLT2 Inhibitor Therapy

RESULTS

Purpose: EMPA-KIDNEY –empagliflozin vs. placebo

EMPA-KIDNEY Reduced progression of kidney disease or cardiovascular Cardiovascular outcomes: Non-significant
• Effects of SGLT2i empagliflozin on CVD, death by 28% reductions observed in:
• Consistent benefit in those with or without cardiovascular disease • Heart failure hospitalization
progressions of kidney disease and need for Reduced the need for hospitalization by 14% • Cardiovascular death or heart failure
• Rates of hospitalization were very high hospitalization
hospitalization with CKD. • Consistent benefit in those with or without cardiovascular disease • Major cardiovascular events
Meta-Analysis of 13 SGLT2i Trials
Meta-Analysis of Major Trials of SGLT2 Inhibitor Therapy
• Effect of SGLT2i on CV and other outcomes
SGLT2i events/participants Placebo events/participants RR (95% CI)
in high-risk groups.
CV Death or Hospitalization for HF (totals)
Design:
Diabetes 3056/40691 3233/34113 0.77 (0.73, 0.81)
EMPA-KIDNEY
• Randomized trial N= 6609 (8 countries), No diabetes 760/7792 943/7813 0.79 (0.72,0.87)

with CKD comparing SGLT2i empagliflozin CV Death (totals) 14% reduction in CV Death

vs placebo. Diabetes 1908/40691 17743/341113 0.86 (0.80,0.92)

Meta-analysis of 13 SGLT2i Trials No diabetes 422/7792 477/7813 0.88 (0.78, 1.01)
• Data analysis of 13 SGLT2i trials involving
Meta-Analysis Results:
90,000 participants with Type 2 Diabetes • With type 2 diabetes: reductions in (i) cardiovascular death (ii) cardiovascular death + heart failure hospitalization in all
groups of high-risk participants
and with or at risk for CVD, HF, CKD. • Without type 2 diabetes reductions in (i) cardiovascular death (ii) cardiovascular death + heart failure hospitalization in
participants with heart failure; but less information in patients with chronic kidney disease.

Presented by: David Preiss, PhD, Medical Research Council Population Health Research Unit,
University of Oxford, UK Scientific Sessions 2022. © 2022, American Heart Association. All rights reserved Results reflect the data available prior to the time of presentation.

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