Physicians' Academy for Cardiovascular Education

Initiation of SGLT2i associated with clinical benefit in acute HF

News - Nov. 14, 2021

Efficacy And Safety Of Empagliflozin In Hospitalized Heart Failure Patients: Main Results From The EMPULSE Trial

Presented at the American Heart Association’s Scientific Sessions 2021 by: Prof. Adriaan Voors, MD, PhD - Groningen, The Netherlands.

Introduction and methods

Aim of the study

The EMPEROR-reduced and EMPEROR-preserved trials demonstrated that the SGLT2 inhibitor empagliflozin reduces the risk of CV or HF hospitalization in patients with chronic HF. This trial investigated whether empagliflozin is safe and improves clinical outcomes in patients hospitalized for acute HF.

Study design

The EMPULSE trial enrolled a total of 530 patients who were hospitalized with a primary diagnosis of acute HF (de novo or decompensated chronic HF), with or without T2DM and regardless of ejection fraction. Mean age of the patients was 68.5 years, 33.8% were women, 45.3% had T2DM, and 31.9% had LVEF>40%. After clinical stabilization, patients were randomized in a 1:1 ratio to receive empagliflozin 10 mg once daily (n=265) or placebo (n=265) for 90 days.


The primary outcome was clinical benefit, which was defined as a hierarchical composite of time to all-cause death, number of HF events (HFE), time to first HFE and change from baseline in KCCQ-TSS after 90 days of treatment. The primary endpoint was assessed by the win ratio of clinical benefit stratified by HF status.

Main results


Initiation of empagliflozin in patients hospitalized with acute HF was associated with clinical benefits within 90 days of treatment, compared to placebo. Empagliflozin was well tolerated in this patient population and the effects on clinical benefit were consistent across all investigated subgroups.

-Our reporting is based on the information provided at the American Heart Association’s Scientific Sessions 2021-

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