Evidence map›Paper›PMID 32410463›Full record

Trial reportCirculation2020

Empagliflozin in Heart Failure: Diuretic and Cardiorenal Effects.

Matthew Griffin, Veena S Rao, Juan Ivey-Miranda, James Fleming, Devin Mahoney, Christopher Maulion, Nisha Suda, Krishmita Siwakoti, Tariq Ahmad, Daniel Jacoby and 10 more

2 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03027960. Cited by 193 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
193citing papers in PubMed, 21 pooled it
37.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03027960 phase1completed

Empagliflozin in Heart Failure: Diuretic and Cardio-Renal Effects

Ran2017Enrolled21Registered outcomes2Posted comparisons0ConditionsHeart Failure, Type II; DiabetesArmsempagliflozin, Placebo Oral Capsule
Open the trial in the graph
NCT05741658 phase4completedstarted 2023, after this paper: background citation

An Open-Label, Non-randomized, Multi-center Pilot Study to Evaluate the Safety and Efficacy of 4-week, Daily Oral Use of Dapagliflozin 10mg Tablet in Adults With a Fontan Circulation

Ran2023Enrolled29Registered outcomes8Posted comparisons0ConditionsHeart FailureArmsDapagliflozin 10mg Tab
PMID 28605608PMID 29526832PMID 30882240PMID 3529918PMID 33189798PMID 32434052PMID 32419592PMID 31916329PMID 31535829PMID 31256636PMID 30377261PMID 26378978other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

193 citing papers in PubMed, 21 syntheses or guidelines pooled it, 394 citations in OpenAlex.

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133 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 7 institutions in 4 countries.

Matthew Griffin *Department of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
Veena S Rao *Department of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
Juan Ivey-MirandaHospital de Cardiologia, Instituto Mexicano del Seguro Social, Mexico City, Mexico (J.I.-M.).
James FlemingDepartment of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
Devin MahoneyDepartment of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
Christopher MaulionDepartment of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
Nisha SudaMontefiore Medical Center, Albert Einstein College of Medicine, New York (N.S.).
Krishmita SiwakotiDepartment of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham (K.S.).
Tariq AhmadDepartment of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
Daniel JacobyDepartment of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
Ralph RielloDivision of Pharmacy (R.R.), Yale University School of Medicine, New Haven, CT.
Lavanya BellumkondaDepartment of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
Zachary CoxDepartment of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, TN (Z.C.).
Sean CollinsDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN (S.C.).
Sangchoon JeonYale School of Nursing, West Haven, CT (S.J.).
Jeffrey M TurnerDepartment of Internal Medicine, Section of Cardiovascular Medicine (M.G., V.S.R., J.F., D.M., C.M., T.A., D.J., L.B., J.M.T.), Yale University School of Medicine, New Haven, CT.
F Perry WilsonClinical and Translational Research Accelerator (F.P.W.), Yale University School of Medicine, New Haven, CT.
Javed ButlerDepartment of Medicine, University of Mississippi, Jackson (J.B.).
Silvio E InzucchiDepartment of Internal Medicine, Section of Endocrinology (S.E.I.), Yale University School of Medicine, New Haven, CT.
Jeffrey M Testani
Yale University · USAlbert Einstein College of Medicine · USLipscomb University · USMexican Social Security Institute · MXUniversity of Alabama at Birmingham · USUniversity of Mississippi · USVanderbilt University Medical Center · US

Funding

Yale Diabetes Research CenterP30DK045735 · YALE UNIVERSITY · 1993 to 2025
$10.2M
Yale Clinical and Translational Science AwardUL1TR001863 · YALE UNIVERSITY · 2025 to 2025
$9.9M
Vascular Training GrantT32HL007950 · YALE UNIVERSITY · 2000 to 2025
$1.8M
NCATS NIH HHS UL1 TR001863NHLBI NIH HHS T32 HL007950NIDDK NIH HHS P30 DK045735
6 · The paper itself

Abstract

backgroundSodium-glucose cotransporter-2 inhibitors improve heart failure-related outcomes. The mechanisms underlying these benefits are not well understood, but diuretic properties may contribute. Traditional diuretics such as furosemide induce substantial neurohormonal activation, contributing to the limited improvement in intravascular volume often seen with these agents. However, the proximal tubular site of action of the sodium-glucose cotransporter-2 inhibitors may help circumvent these limitations.

methodsTwenty patients with type 2 diabetes mellitus and chronic, stable heart failure completed a randomized, placebo-controlled crossover study of empagliflozin 10 mg daily versus placebo. Patients underwent an intensive 6-hour biospecimen collection and cardiorenal phenotyping at baseline and again after 14 days of study drug. After a 2-week washout, patients crossed over to the alternate therapy with the above protocol repeated.

resultsOral empagliflozin was rapidly absorbed as evidenced by a 27-fold increase in urinary glucose excretion by 3 hours (

conclusionsEmpagliflozin causes significant natriuresis, particularly when combined with loop diuretics, resulting in an improvement in blood volume. However, off-target electrolyte wasting, renal dysfunction, and neurohormonal activation were not observed. This favorable diuretic profile may offer significant advantage in the management of volume status in patients with heart failure and may represent a mechanism contributing to the superior long-term heart failure outcomes observed with these agents. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03027960.

Indexed as

Benzhydryl CompoundsDiabetes ComplicationsDiabetes Mellitus, Type 2DiureticsGlucosidesHeart FailureAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedBenzhydryl CompoundsDiureticsempagliflozinGlucosidesblood volumenatriuresissodium-glucose transporter 2 inhibitors

Identifiers

PMID32410463
PMCPMC7521417
OpenAlexW3025899746

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.