Evidence mapPaperPMID 40947857Full record

Trial reportESC heart failure2025

Empagliflozin after myocardial infarction with or without diabetes and chronic kidney disease: Insights from EMPACT-MI.

Francesco Fioretti, Javed Butler, Jacob A Udell, W Schuyler Jones, Mark C Petrie, Josephine Harrington, Michaela Mattheus, Johann Bauersachs, Antoni Bayes-Genis, Shaun G Goodman and 14 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Trial
  3. Review
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

24 authors.

Francesco FiorettiBaylor Scott & White Research Institute, Dallas, Texas, USA.
Javed ButlerBaylor Scott & White Research Institute, Dallas, Texas, USA.
Jacob A UdellWomen's College Hospital and Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Canada.
W Schuyler JonesDivision of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Mark C PetrieSchool of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Josephine HarringtonDivision of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Michaela MattheusBoehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany.
Johann BauersachsDepartment of Cardiology and Angiology, Hannover Medical School, Hanover, Germany.
Antoni Bayes-GenisHeart Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Shaun G GoodmanCanadian VIGOUR Centre, University of Alberta, Edmonton, Canada.
Tomasz GasiorBoehringer Ingelheim International GmbH, Ingelheim, Germany.
James L JanuzziDivision of Cardiology, Harvard Medical School and Massachusetts General Hospital, Baim Institute for Clinical Research, Boston, Massachusetts, USA.
Renato D LopesDivision of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Piotr PonikowskiInstitute for Heart Diseases, Wrocław Medical University, Wrocław, Poland.
Xavier RosselloHospital Universitari Son Espases, Health Research Institute of the Balearic Islands, University of the Balearic Islands, Palma de Mallorca, Spain.
Morten SchouDepartment of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark.
Peter van der MeerDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Dragos VinereanuUniversity of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania.
Shelley ZierothSection of Cardiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
Martina BrueckmannBoehringer Ingelheim International GmbH, Ingelheim, Germany.
Mikhail SuminBoehringer Ingelheim International GmbH, Ingelheim, Germany.
Deepak L BhattMount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Adrian F HernandezDivision of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Stefan D AnkerDepartment of Cardiology (CVK), German Heart Center Charité, German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Funding

Boehringer Ingelheim and Eli Lilly and Company Diabetes Alliance
6 · The paper itself

Abstract

backgroundIn the EMPACT-MI trial, empagliflozin did not reduce the primary endpoint of all-cause mortality or hospitalization for heart failure (HHF) following acute myocardial infarction (AMI) but was associated with a risk reduction for HF events.

objectivesThis study aimed to evaluate whether the effect of empagliflozin on HF events is consistent in patients with and without type 2 diabetes and/or chronic kidney disease enrolled in the EMPACT-MI trial.

methodsPost hoc analysis assessing the effect of empagliflozin on the primary endpoint and on HF events in AMI patients with and without an established recommendation for a sodium-glucose cotransporter-2 inhibitor (SGLT2i) (type 2 diabetes or chronic kidney disease).

resultsOf 6522 participants, 3489 (53%) did not have type 2 diabetes and/or chronic kidney disease. Those without these conditions were younger and with fewer comorbidities. No differences were observed for the primary endpoint. Empagliflozin reduced time to first HHF, total HHF, time to adverse event (AE) of HF (including outpatient HF events) and total AEs of HF similarly in patients with and without type 2 diabetes or chronic kidney disease. Total HHFs were 50 and 63 [adjusted event rate 1.74 and 2.31 events per 100 patient-years; rate ratio (RR) 0.75; 95% confidence interval (CI) 0.48, 1.18] in patients without and 98 and 144 (adjusted event rate 3.91 and 6.04 events per 100 patient-years; RR 0.65; 95% CI 0.45, 0.94; P for interaction = 0.61) in those with type 2 diabetes or chronic kidney disease in the empagliflozin and placebo arms, respectively. Any AEs, serious AEs and AEs leading to permanent study drug discontinuation were similar between treatment groups in both subgroups.

conclusionsEmpagliflozin improved HF outcomes similarly in patients after AMI with or without type 2 diabetes or chronic kidney disease.

Indexed as

Benzhydryl CompoundsDiabetes Mellitus, Type 2GlucosidesHeart FailureMyocardial InfarctionRenal Insufficiency, ChronicAgedDouble-Blind MethodFemaleFollow-Up StudiesHumansMaleMiddle AgedSodium-Glucose Transporter 2 InhibitorsTreatment OutcomeBenzhydryl CompoundsempagliflozinGlucosidesSodium-Glucose Transporter 2 InhibitorsCKDdiabetesheart failuremyocardial infarctionrecommendationSGLT2i

Identifiers

PMID40947857
PMCPMC12719805

What Socratic holds

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Registered trials

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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.