Impact of empagliflozin on insulin use in patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes: sub-analysis from EMPEROR-Preserved trial

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Key messages

• Patients with heart failure (HF) and a preserved ejection fraction (HFpEF) often have type 2 diabetes (T2DM) and require insulin therapy.
• The randomized, placebo-controlled EMPEROR-Preserved trial assessed the impact of empagliflozin 10 mg on insulin requirement and clinical outcomes according to insulin use in 5,988 patients with T2DM/prediabetes (preDM).
• Empagliflozin reduced the rate of insulin initiation by 31% in patients with HFpEF and T2DM/preDM.
• Risk of adverse cardiovascular (CV) outcomes in patients with T2DM who used insulin at baseline was higher vs patients not using insulin.
• The beneficial effects of empagliflozin on CV outcomes were consistent in patients with T2DM, regardless of insulin treatment.