- Question
- Does starting empagliflozin during hospitalization for acute heart failure, once the patient is stabilized, improve clinical outcomes at 90 days?
- Design
- Multinational, randomized, double-blind, placebo-controlled trial of 530 patients. Randomization took place in hospital when patients were clinically stable (median 3 days from admission), and treatment continued for up to 90 days.
- Population
- Patients hospitalized with a primary diagnosis of acute heart failure, either de novo or decompensated chronic, regardless of left ventricular ejection fraction.
- Intervention
- Empagliflozin 10 mg once daily.
- Control
- Placebo.
- Primary outcome
- Clinical benefit, a hierarchical composite of all-cause death, number of heart failure events, time to first heart failure event, and a difference of 5 points or more in change from baseline in the Kansas City Cardiomyopathy Questionnaire Total Symptom Score at 90 days, assessed with a win ratio.
- Results
- More patients treated with empagliflozin had clinical benefit than with placebo (stratified win ratio 1.36; 95% CI 1.09-1.68; P = 0.0054). The benefit was seen in both de novo and decompensated chronic heart failure, and regardless of ejection fraction or diabetes status.
- Safety
- Empagliflozin was well tolerated; serious adverse events were reported in 32.3% of empagliflozin-treated and 43.6% of placebo-treated patients.
- Conclusion
- Starting empagliflozin in patients hospitalized for acute heart failure is well tolerated and results in significant clinical benefit in the 90 days after initiation.
- Why it matters
- It provided evidence that an SGLT2 inhibitor can be started safely during hospitalization for acute heart failure, extending its use beyond the outpatient, stable chronic setting.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026