Remarkable win streak for SGLT2i drugs continues…now specifically for heart failure with preserved ejection fraction (HFpEF), where effective therapies are scarce. Empagloflozin benefits one of every ~30 people treated over median of 26 mos. nejm.org/doi/full/10.10… #ESCCongress 
What gives me confidence about the finding is it is consistent w/what we have seen in subgroups of other studies, but not yet in a dedicated trial. Kudos @JavedButler1 Stefan Anker and team. This is truly a landmark in heart failure care. #ESCCongress2021 #ESCcongress @escardio
@JavedButler1 @escardio Another notable about this EMPEROR-Preserved trial… empaglifozin won across a range of outcomes, across all the subgroups (incl people w/o diabetes), and w/o evidence of safety issues (more serious safety issues in the placebo group). Very welcome set of findings. #ESCcongress
@JavedButler1 @escardio Questions that remain… is this a class effect (will be tested with the upcoming DELIVER trial that uses dapagliflozin); what is the mechanism of the benefit (still a debate, though of academic interest); what about other populations not well represented in the study...
@JavedButler1 @escardio To add more detail on the study population… mean age 71; 45% women; 4% Black people. Mostly from Europe and Latin America. 12% from North America. About half with diabetes. Two-thirds with ejection fraction > 50%. A quarter hospitalized for heart failure in the last year.
@JavedButler1 @escardio Subgroup analysis is almost always exploratory… but I am impressed that all the point estimates are on the side of benefit. These are no longer just diabetes drugs. More studies will be necessary to understand better if there is heterogeneity across subgroups… #ESCCongress2021
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