Article Impact Level: HIGH Data Quality: STRONG Summary of Circulation, 2022 (Ahead of print) Dr. P. Christian Schulze et al
Points
- Acute decompensated heart failure patients were randomly administered either 25 mg of empagliflozin or placebo daily in a double-blind randomized study with five (5)-day cumulative urine output as an endpoint
- Empagliflozin was administered in conjunction with standard decongestive treatments, including loop diuretics
- Patients undergoing empagliflozin medication alongside diuretic therapy for acute decompensated heart failure experienced increased urine output without affecting renal function
Summary
Patients who suffer acute decompensated heart failure (ADHF) often use diuretic treatments. After all, heart complications of this nature are often accompanied by elevated blood pressure; diuretic treatments reduce this by helping the patient’s kidneys release more water and salts from within your body. Ejecting salts from the body helps reduce water levels in the bloodstream, which in turn is associated with a reduction of blood pressure via reduction of blood fluid overload. The nature of this treatment, however, strains the kidneys, which sometimes leads to kidney-related complications and a reduction in function.
A novel approach developed to circumvent this impairment using the antidiabetic medication empagliflozin was designed in a single-center, prospective, double-blind, placebo-controlled, randomized study involving sixty (60) ADHF patients. Patients were randomly assigned to either 25 mg of empagliflozin or placebo, which was added to their standard loop diuretic treatment regimens. Cumulative urine output was measured over five (5) days and was recorded as the primary end point of the study. Secondary end points included diuretic efficiency, marker dynamics for kidney function, and N-terminal pro-B-type natriuretic peptide (NT-proBNP), a hormone secreted by cardiomyocytes in heart ventricles in response to stretching from increased blood volume.
Sixty (60) patients were randomized within 12 hours of ADHF hospitalization. Daily empagliflozin medications in conjunction with standard diuretics treatments caused a 25% increase in urine output over five (5) days, with a median 10.8 mL collected from medicated patients over 5 days compared to the median 8.7 mL collected from those under placebo. Treatment with empagliflozin also improved diuretic efficiency compared to placebo, all without impacting renal function markers. NT-proBNP levels in empagliflozin patients also experienced a pronounced decrease compared to placebo.
Overall, adding empagliflozin to the early stages of ADHF standard diuretics increased urine output in patients without sacrificing renal function.
Link to the article: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.059038
References Schulze, P. C., Bogoviku, J., Westphal, J., Aftanski, P., Haertel, F., Grund, S., von Haehling, S., Schumacher, U., Möbius-Winkler, S., & Busch, M. (n.d.). Effects of early empagliflozin initiation on diuresis and kidney function in patients with acute decompensated heart failure(Empag-hf). Circulation, 0(0), 10.1161/CIRCULATIONAHA.122.059038. https://doi.org/10.1161/CIRCULATIONAHA.122.059038
