Thread by @HanCardiomd

In patients with #HFpEF, treatment with #empagliflozin improves clinical outcomes regardless of background #MRA therapy

jacc.org/doi/10.1016/j.…
@JACCJournals #JACC @unic_cardiovasc @JavedButler1 @FaiezZANNAD #MiltonPacker @robmentz @BiykemB @HFpEF @ShelleyZieroth

#MRAs were used in 37% of EMPEROR-Preserved study participants. MRA use was higher in those with a more congested clinical picture, with more HF🏥 within the past 12 months, worse HF symptoms, mildly reduced EF, higher NT-proBNP levels, and more use of loop diuretic agents

The effect of empagliflozin to reduce HF 🏥 was more pronounced in MRA nonusers than in MRA users, particularly in the subgroup of patients with LVEFs ≥50% @HFpEF @DrRyanPDaly @AndrewJSauer @AnastasiaSMihai @DrMarthaGulati @ErinMichos @ShelleyZieroth @mvaduganathan

Importantly, MRA users had higher rates of hyperkalemia compared with MRA nonusers, but empagliflozin reduced hyperkalemia events and the use of potassium-binding agents.
#Flozinators #MRA #Hyperkalemia @ErinMichos @AndrewJSauer @JavedButler1 @JJheart_doc @pabeda1 @rachkataria

In patients with #HFrEF, #MRAs are recommended to reduce HF hospitalizations and mortality.

In contrast, in patients with #HFpEF, MRAs have weaker evidence.

These differences in the strength of evidence for #MRA use between #HFrEF and #HFpEF were reflected in the #EMPEROR program

📌EMPEROR-Reduced ; > 70% of pts were using MRAs at baseline

📌EMPEROR-Preserved ; <40% of were MRA user typically in the patients with advanced HF

EMPEROR-Preserved confirmed prior findings of a reduced incidence of #hyperkalemia, or initiation of potassium binders, by empagliflozin.

As expected, MRA users experienced more frequent hyperkalemic events than nonusers .@AnastasiaSMihai @rachkataria @SolovevaAnzhela @pabeda1

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