Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes

The New England Journal of Medicine
Bernard ZinmanEMPA-REG OUTCOME Investigators

Abstract

The effects of empagliflozin, an inhibitor of sodium-glucose cotransporter 2, in addition to standard care, on cardiovascular morbidity and mortality in patients with type 2 diabetes at high cardiovascular risk are not known. We randomly assigned patients to receive 10 mg or 25 mg of empagliflozin or placebo once daily. The primary composite outcome was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, as analyzed in the pooled empagliflozin group versus the placebo group. The key secondary composite outcome was the primary outcome plus hospitalization for unstable angina. A total of 7020 patients were treated (median observation time, 3.1 years). The primary outcome occurred in 490 of 4687 patients (10.5%) in the pooled empagliflozin group and in 282 of 2333 patients (12.1%) in the placebo group (hazard ratio in the empagliflozin group, 0.86; 95.02% confidence interval, 0.74 to 0.99; P=0.04 for superiority). There were no significant between-group differences in the rates of myocardial infarction or stroke, but in the empagliflozin group there were significantly lower rates of death from cardiovascular causes (3.7%, vs. 5.9% in the placebo group; 38% relative risk reduction), hospitalization...Continue Reading

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Oct 18, 2018·Diabetes Care·Katrine M LauritsenLars C Gormsen
Dec 25, 2018·Arteriosclerosis, Thrombosis, and Vascular Biology·Paolo RaggiJonathan Abele
Jan 16, 2019·Expert Review of Clinical Pharmacology·Angelo Maria PattiAli A Rizvi
Oct 6, 2018·Diabetes Care·Julio RosenstockBruce A Perkins
Dec 27, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Elisabeth SchwaigerManfred Hecking
Sep 27, 2018·Annual Review of Medicine·Caroline K Kramer, Bernard Zinman
Jan 29, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Ann M McNeillEuan McLeod
Jan 31, 2019·Journal of Cellular Physiology·David León JiménezJosé Pablo Miramontes González
Feb 1, 2019·Circulation·Emelia J BenjaminAmerican Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee
Feb 1, 2019·Circulation Research·Michiel CoppensJohn W A Eikelboom
Feb 2, 2019·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Ralph A DeFronzoSteven E Nissen
Feb 6, 2018·Current Diabetes Reports·André J Scheen
Feb 7, 2018·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Shigehiro KatayamaMasashi Issiki
Feb 8, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Cheryl NeslusanLien Vo
Feb 8, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Maria J Peláez-JaramilloCarlos O Mendivil
Jan 5, 2019·Current Opinion in Cardiology·Bradley Brochu, Michael Chan
Feb 9, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Sarah J HallbergJeff S Volek
Feb 7, 2019·Expert Review of Endocrinology & Metabolism·Juan P Frias
Sep 28, 2018·Diabetes, Obesity & Metabolism·Michael A NauckLEADER Publication Committee for the LEADER Trial Investigators
Feb 6, 2019·International Journal of Molecular Sciences·Tuba M AnsaryAkira Nishiyama
Feb 12, 2019·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Alan J GarberGuillermo E Umpierrez
Nov 25, 2018·Diabetes, Obesity & Metabolism·Ruth L M Cordiner, Ewan R Pearson
Feb 13, 2019·Internal and Emergency Medicine·Matteo LandolfoClaudio Borghi
Jan 5, 2019·Diabetes, Obesity & Metabolism·Dario GiuglianoKatherine Esposito
Apr 29, 2018·Journal of Endocrinological Investigation·Dario GiuglianoKatherine Esposito
Oct 20, 2018·Heart·Matthew Meng Yang LeeMark C Petrie
May 10, 2017·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Marlys H LeBrasSheri L Koshman
Jul 27, 2017·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Daniel Wolverton, Melissa M Blair
Feb 20, 2019·Journal of the American Heart Association·David Aguilar
Jan 30, 2019·The Nurse Practitioner·Sarah Aldrich, Emily Ashjian
Jan 29, 2019·American Journal of Hypertension·Lin ShiFen Li
Feb 7, 2019·Postgraduate Medicine·Jeffrey Freeman
Mar 10, 2016·Obstetrics and Gynecology·Silvio E Inzucchi, Sachin K Majumdar
Mar 1, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Atsutaka YasuiTomoo Okamura
Mar 5, 2019·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·Ian Warbrick, Simon W Rabkin
Mar 7, 2018·Scientific Reports·Michitsugu KamezakiKeiichi Tamagaki
Mar 6, 2019·Expert Opinion on Pharmacotherapy·Genya Aharon-Hananel, Itamar Raz
Mar 11, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Martin HaluzikNebojsa Lalic
Feb 28, 2019·Expert Opinion on Drug Safety·Vasilios AthyrosMichael Doumas
Feb 14, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Viswanathan MohanKamlesh Khunti
Feb 14, 2019·Postgraduate Medicine·Theodosios FilippatosMoses Elisaf
Mar 2, 2019·Expert Opinion on Drug Metabolism & Toxicology·Alvaro Garcia-RoperoJuan J Badimon
Mar 12, 2019·Circulation·Janani RangaswamiAmerican Heart Association Council on the Kidney in Cardiovascular Disease and Council on Clinical Cardiology
Jan 29, 2019·Diabetes, Obesity & Metabolism·Darren K McGuireJyothis T George
Mar 13, 2019·International Journal of Molecular Sciences·Jovana Nikolajević StarčevićMišo Šabovič
Mar 14, 2019·Journal of Diabetes Science and Technology·Karel KostevStefan Pscherer
May 4, 2017·Journal of the American Society of Nephrology : JASN·Joshua J NeumillerKatherine R Tuttle
May 20, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Radica Z AlicicKatherine R Tuttle
Mar 4, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Erik J M van BommelDaniël H van Raalte
Mar 18, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Sergei I PetrykivHiddo J L Heerspink
Dec 19, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Maarten A de JongMartin H de Borst
Dec 19, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Daniel Edmonston, Myles S Wolf
Oct 20, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Lili Tong, Sharon G Adler
Feb 15, 2019·Diabetes, Obesity & Metabolism·Clifford J Bailey
Jun 15, 2018·Endocrinology, Diabetes & Metabolism Case Reports·Gordon SloanNishant Ranjan
Feb 14, 2019·Drugs·Dan PughNeeraj Dhaun
Mar 19, 2019·Circulation·Eri Toda KatoStephen D Wiviott
Mar 19, 2019·Circulation·Subodh Verma, John McMurray
Feb 2, 2019·Diabetes Care·Silvio E InzucchiBernard Zinman
Feb 26, 2019·Diabetic Medicine : a Journal of the British Diabetic Association·L A Wright, Irl B Hirsch
Mar 29, 2019·Expert Opinion on Pharmacotherapy·Emanuel RaschiFabrizio De Ponti
Apr 1, 2019·Journal of Cellular and Molecular Medicine·Sonia Khemais-BenkhiatValérie B Schini-Kerth
Mar 14, 2019·Clinical Endocrinology·Zeeshan JavedThozhukat Sathyapalan