Physicians' Academy for Cardiovascular Education

Decongestive effects of SGLT2i in acute HF

News - May 25, 2022

The impact of empagliflozin on decongestion in patients hospitalized for acute heart failure

Presented at ESC Heart Failure 2022 by Prof. Piotr Ponikowski, MD (Wroclaw, Poland)

Introduction and methods

The EMPULSE trial previously showed that treatment with empagliflozin in patients hospitalized for acute HF resulted in a significant clinical benefit compared with placebo. This analysis of the EMPULSE trial investigated the potential decongestive effects of empagliflozin compared with placebo in addition to standard medical treatment.

A total of 530 patients with a primary diagnosis of acute HF (de novo or decompensated chronic HF, HFrEF or HFpEF, with or without T2DM) were randomized after clinical stabilization in a 1:1 ratio to receive either empagliflozin (10 mg daily) or placebo for 90 days.

The following decongestion markers were investigated in the current analysis: weight loss, weight loss adjusted for mean daily loop diuretic dose, AUC of change from baseline in NT-proBNP levels, hemoconcentration, and change in clinical congestion score.

Main results


Prof. Ponikowski concluded that initiation of empagliflozin in patients hospitalized for acute HF resulted in greater changes of decongestion markers compared with placebo. Decongestion was seen early (at day 15) and was sustainable (until day 90).

– Our coverage of ESC Heart Failure 2022 is based on the information provided during the congress –

Read our summary of the EMPULSE trial

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