Evidence mapPaperPMID 39196095Full record

Trial reportNature cardiovascular research2023

Empagliflozin effects on iron metabolism as a possible mechanism for improved clinical outcomes in non-diabetic patients with systolic heart failure.

Christiane E Angermann, Carlos G Santos-Gallego, Juan Antonio Requena-Ibanez, Susanne Sehner, Tanja Zeller, Louisa M S Gerhardt, Christoph Maack, Javier Sanz, Stefan Frantz, Valentin Fuster and 2 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Nature cardiovascular research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03485222. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
field-weighted citation impact
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.

NCT03485222 phase4completed

EMPA-TROPISM Trial: Are the "Cardiac Benefits" of Empagliflozin Independent of Its Hypoglycemic Activity?

Ran2018Enrolled84Registered outcomes6Posted comparisons0ConditionsCardiovascular DiseasesArmsempagliflozin, Placebos
PMID 33197559other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  5. Canagliflozin and iron metabolism in the CREDENCE trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025 · on this map
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Christiane E AngermannComprehensive Heart Failure Center, Würzburg University and University Hospital Würzburg, and Department of Medicine 1, University Hospital Würzburg, Würzburg, Germany. angermann_c@ukw.de.ORCID http://orcid.org/0000-0001-7491-7637
Carlos G Santos-GallegoAtherothrombosis Research Unit, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Juan Antonio Requena-IbanezAtherothrombosis Research Unit, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Susanne SehnerInstitute of Medical Biometry and Epidemiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.ORCID http://orcid.org/0000-0002-2415-9302
Tanja ZellerUniversity Center of Cardiovascular Science, University Heart and Vascular Center, University Hospital Hamburg-Eppendorf, and German Center of Cardiovascular Research, Partner Site Hamburg - Kiel - Lübeck, Hamburg, Germany.ORCID http://orcid.org/0000-0003-3379-2641
Louisa M S GerhardtDepartment of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.ORCID http://orcid.org/0000-0003-3052-1563
Christoph MaackComprehensive Heart Failure Center, Würzburg University and University Hospital Würzburg, and Department of Medicine 1, University Hospital Würzburg, Würzburg, Germany.ORCID http://orcid.org/0000-0003-3694-4559
Javier SanzAtherothrombosis Research Unit, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Stefan FrantzComprehensive Heart Failure Center, Würzburg University and University Hospital Würzburg, and Department of Medicine 1, University Hospital Würzburg, Würzburg, Germany.
Valentin FusterAtherothrombosis Research Unit, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Georg ErtlComprehensive Heart Failure Center, Würzburg University and University Hospital Würzburg, and Department of Medicine 1, University Hospital Würzburg, Würzburg, Germany.
Juan J BadimonAtherothrombosis Research Unit, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sodium-glucose co-transporter-2 (SGLT2) inhibitors improve clinical outcomes in patients with heart failure (HF), but mechanisms of action are incompletely understood. In the EMPA-TROPISM trial, empagliflozin reversed cardiac remodeling and increased physical capacity in stable non-diabetic patients with systolic HF. Here we explore, post hoc, whether treatment effects in this cohort, comprising patients who had a high prevalence of iron deficiency, were related to iron metabolism. Myocardial iron content estimated by cardiac magnetic resonance T2* quantification increased after initiation of empagliflozin but not placebo (treatment effect: P = 0.01). T2* changes significantly correlated with changes in left ventricular volumes, mass and ejection fraction, peak oxygen consumption and 6-minute walking distance; concomitant changes in red blood cell indices were consistent with augmented hematopoiesis. Exploratory causal mediation analysis findings indicated that changes in myocardial iron content after treatment with empagliflozin may be an important mechanism to explain its beneficial clinical effects in patients with HF.ClinicalTrials.gov: NCT03485222 .

Indexed as

Benzhydryl CompoundsGlucosidesHeart Failure, SystolicIronSodium-Glucose Transporter 2 InhibitorsAgedBiomarkersExercise ToleranceFemaleHumansMaleMiddle AgedMyocardiumRecovery of FunctionStroke VolumeTime FactorsBenzhydryl CompoundsBiomarkersempagliflozinGlucosidesIronSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID39196095
PMCPMC11358002

What Socratic holds

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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.