Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure
Abstract Aims In this prospective, placebo‐controlled, double‐blind, exploratory study, we examined early and more delayed effects of empagliflozin treatment on haemodynamic parameters (primary endpoint: cardiac output) and kidney function including parameters of acute kidney injury (AKI) in patient...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-08-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13955 |
| _version_ | 1828541769225076736 |
|---|---|
| author | Kirsten Thiele Matthias Rau Niels‐Ulrik Korbinian Hartmann Marcus Möller Julia Möllmann Joachim Jankowski András P. Keszei Michael Böhm Jürgen Floege Nikolaus Marx Michael Lehrke |
| author_facet | Kirsten Thiele Matthias Rau Niels‐Ulrik Korbinian Hartmann Marcus Möller Julia Möllmann Joachim Jankowski András P. Keszei Michael Böhm Jürgen Floege Nikolaus Marx Michael Lehrke |
| author_sort | Kirsten Thiele |
| collection | DOAJ |
| description | Abstract Aims In this prospective, placebo‐controlled, double‐blind, exploratory study, we examined early and more delayed effects of empagliflozin treatment on haemodynamic parameters (primary endpoint: cardiac output) and kidney function including parameters of acute kidney injury (AKI) in patients with acute decompensated heart failure (HF). Methods and results Patients with acute decompensated HF with or without diabetes were randomized to empagliflozin 10 mg or placebo for 30 days. Haemodynamic, laboratory, and urinary parameters were assessed after 6 h, 1 day, 3 days, 7 days, and 30 days of treatment. Median time between hospital admission and randomization was 72 h. Baseline characteristics were not different in the empagliflozin (n = 10) and placebo (n = 9) groups. Empagliflozin led to a significant increase in urinary glucose excretion throughout the study (baseline: 37 ± 15 mg/24 h; Day 1: 14 565 ± 8663 mg/24 h; P = 0.001). Empagliflozin did not affect the primary endpoint of cardiac index or on systemic vascular resistance index at any time point. However, empagliflozin significantly reduced parameters of AKI (urinary TIMP‐2 and IGFBP7 by NephroCheck® as indicators of tubular kidney damage), which became significant after 3 days of treatment [placebo: 1.1 ± 1.1 (ng/mL)2/1000; empagliflozin: 0.3 ± 0.2 (ng/mL)2/1000; P = 0.02] and remained significant at the 7 day time point [placebo: 2.5 ± 3.8 (ng/mL)2/1000; empagliflozin: 0.3 ± 0.2 (ng/mL)2/1000; P = 0.003]. Conclusions In this study, empagliflozin treatment did not affect haemodynamic parameters but significantly reduced markers of tubular injury in patients with acute decompensated HF. |
| first_indexed | 2024-12-12T01:44:39Z |
| format | Article |
| id | doaj.art-9f17b380cf264a34a7626044cd0ebb45 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-12T01:44:39Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-9f17b380cf264a34a7626044cd0ebb452022-12-22T00:42:37ZengWileyESC Heart Failure2055-58222022-08-01942233223810.1002/ehf2.13955Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failureKirsten Thiele0Matthias Rau1Niels‐Ulrik Korbinian Hartmann2Marcus Möller3Julia Möllmann4Joachim Jankowski5András P. Keszei6Michael Böhm7Jürgen Floege8Nikolaus Marx9Michael Lehrke10Department of Internal Medicine I University Hospital Aachen, RWTH Aachen University Aachen GermanyDepartment of Internal Medicine I University Hospital Aachen, RWTH Aachen University Aachen GermanyDepartment of Internal Medicine I University Hospital Aachen, RWTH Aachen University Aachen GermanyDepartment of Internal Medicine II University Hospital Aachen, RWTH Aachen University Aachen GermanyDepartment of Internal Medicine I University Hospital Aachen, RWTH Aachen University Aachen GermanyInstitute for Molecular Cardiovascular Research University Hospital Aachen, RWTH Aachen University Aachen GermanyCenter for Translational & Clinical Research Aachen (CTC‐A) RWTH Aachen University Aachen GermanyDepartment of Internal Medicine III University Hospital Saarland, Saarland University Homburg Saar GermanyDepartment of Internal Medicine II University Hospital Aachen, RWTH Aachen University Aachen GermanyDepartment of Internal Medicine I University Hospital Aachen, RWTH Aachen University Aachen GermanyDepartment of Internal Medicine I University Hospital Aachen, RWTH Aachen University Aachen GermanyAbstract Aims In this prospective, placebo‐controlled, double‐blind, exploratory study, we examined early and more delayed effects of empagliflozin treatment on haemodynamic parameters (primary endpoint: cardiac output) and kidney function including parameters of acute kidney injury (AKI) in patients with acute decompensated heart failure (HF). Methods and results Patients with acute decompensated HF with or without diabetes were randomized to empagliflozin 10 mg or placebo for 30 days. Haemodynamic, laboratory, and urinary parameters were assessed after 6 h, 1 day, 3 days, 7 days, and 30 days of treatment. Median time between hospital admission and randomization was 72 h. Baseline characteristics were not different in the empagliflozin (n = 10) and placebo (n = 9) groups. Empagliflozin led to a significant increase in urinary glucose excretion throughout the study (baseline: 37 ± 15 mg/24 h; Day 1: 14 565 ± 8663 mg/24 h; P = 0.001). Empagliflozin did not affect the primary endpoint of cardiac index or on systemic vascular resistance index at any time point. However, empagliflozin significantly reduced parameters of AKI (urinary TIMP‐2 and IGFBP7 by NephroCheck® as indicators of tubular kidney damage), which became significant after 3 days of treatment [placebo: 1.1 ± 1.1 (ng/mL)2/1000; empagliflozin: 0.3 ± 0.2 (ng/mL)2/1000; P = 0.02] and remained significant at the 7 day time point [placebo: 2.5 ± 3.8 (ng/mL)2/1000; empagliflozin: 0.3 ± 0.2 (ng/mL)2/1000; P = 0.003]. Conclusions In this study, empagliflozin treatment did not affect haemodynamic parameters but significantly reduced markers of tubular injury in patients with acute decompensated HF.https://doi.org/10.1002/ehf2.13955SGLT2 inhibitorsEmpagliflozinAcute decompensated heart failureAcute kidney injuryHaemodynamic parameters |
| spellingShingle | Kirsten Thiele Matthias Rau Niels‐Ulrik Korbinian Hartmann Marcus Möller Julia Möllmann Joachim Jankowski András P. Keszei Michael Böhm Jürgen Floege Nikolaus Marx Michael Lehrke Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure ESC Heart Failure SGLT2 inhibitors Empagliflozin Acute decompensated heart failure Acute kidney injury Haemodynamic parameters |
| title | Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure |
| title_full | Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure |
| title_fullStr | Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure |
| title_full_unstemmed | Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure |
| title_short | Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure |
| title_sort | empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure |
| topic | SGLT2 inhibitors Empagliflozin Acute decompensated heart failure Acute kidney injury Haemodynamic parameters |
| url | https://doi.org/10.1002/ehf2.13955 |
| work_keys_str_mv | AT kirstenthiele empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT matthiasrau empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT nielsulrikkorbinianhartmann empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT marcusmoller empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT juliamollmann empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT joachimjankowski empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT andraspkeszei empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT michaelbohm empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT jurgenfloege empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT nikolausmarx empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure AT michaellehrke empagliflozinreducesmarkersofacutekidneyinjuryinpatientswithacutedecompensatedheartfailure |