Is Empagliflozin a New Drug in the Making for Patients with Acute Decompensated Heart Failure?

Abstract

Abstract
Background and Objectives: Empagliflozin has dramatically enhanced outcomes in heart failure patients.
The objective was to study the effect of Empagliflozin in acute setting as add-on treatment on cardiac
hemodynamic by measuringpulmonarycapillarywedgepressure (PCWP) andbyEchocardio-graphy
Methods: It was a prospective observational study conducted on 75 patients presenting with acute heart
failure at Chaudhary Muhammad Akram Teaching & Research Hospital Lahore,(CMAT & RH) with 4 days
in-hospital echocardiographic follow up. After taking approval from IRB & written informed consent from
patient, a questionnaire was used as data collection tool with information regarding basic demographic
features prescribing empagliflozin as well as PCWP on day 0, day 1 & day 3 after fulfilling the inclusion
criteria and results were calculated using Statistical Package for Social Sciences (SPSS) version v 20 32 bit.
Results: In our study, the mean age of participants was 57.5±7 years with 24% males (n=18) and 76%
females (n=57). 93.3% of participants were known hypertensive, 57.3% were diabetic, 21.3% of cases were
having significant family history of ischemic heart disease. Among all, 64% were having 2 or less risk factors
and 36% were having more than 2 risk factors. In accordance to symptoms, 35% of participants were having
NYHA class II to III symptoms and 65% were in NYHA class IV. 53% of participants were having chronic
heart failure symptoms while 43% were having denovo symptoms. Among them, 42% were started with
25mg/day empagliflozin and 58% were started with 10mg/day according to their symptoms and
requirements. Mean PCWP calculated at Day 0 was 22+7.5mmHg reduced to 14.3±5.2 mmHg at 1st day
and10.6±3.3 mmHg at 2nd day after therapy which was statistically significant (p value=0.041).
Conclusion: This study concluded that addition of Empagliflozin to standard treatment significantly reduced
PCWPin patients having acute decompensated heart failure.
Key Words: Pulmonary capillary wedge pressure(PCWP), Empagliflozin, Heart failure (HF).