Watch the full video on Radcliffe Cardiology here:
Hi i’m michael casibaro i’m a cardiologist at saint luke’s mid-america heart institute in this uh analysis of impulse trial uh we looked at the effects of amperage flows in agility to inhibitor on health status which is symptoms uh physical limitations and quality of life in patients uh hospitalized with acute heart failure just to take a step back we presented
The main result of impulse at the american heart association a few months ago and it was just published recently and uh it’s important to keep in mind that patients hospitalized with acute heart failure uh experience very high burden of symptoms in physical limitations and poor quality of life and we have dearths of therapies that can be effective in improving
Those outcomes in the main impulse study we previously showed that ampligly floating is compared with placebo significantly improved what we call total clinical benefit which is a composite direct composite of death recurrent heart failure events and change in cancer cardiomyopathy questionnaire which is a measure of symptoms physical limitations in quality of
Life but in this analysis specifically we wanted to concentrate on the effects of public loads and on those very um outcomes uh very important outcomes to patients with uh acute heart failure which is the symptom burdens the burden of physical limitations and the poor quality of life impulse trial enrolled over 500 patients as it were hospitalized with acute heart
Failure it’s really a new trial in many ways because uh it included patients uh with acute heart failure regardless of the ejection fraction so both those who reduce the preserved ejection fraction uh were enrolled as well as those with or without diabetes and also those with either worsening chronic heart failure or de novo heart failure which means that with
A new diagnosis because heart failure patients were hospitalized with so all of those patient types of patients were included in the study and while in hospitals they were randomized to either ampugleflozen or placebo and treat it for 90 days specifically for the outcomes that we concentrated on in this analysis cancer cardiomyopathy questionnaire which is the
Gold standard of health status that was assessed at randomization as well as 15 30 and 90 days so uh in this particular analysis there were two key objectives one is to evaluate the effect of epiglottis and on the primary endpoint which was a total clinical benefit uh across the tortillas of cancer karma cardiomyopathy questionnaire scores so essentially to
Try to understand what is the clinical total clinical benefit of tempegoflozen differs depending on the degree of symptomatic impairment of baseline and second perhaps even more importantly uh to look at the effect of amperglucen on symptoms physical limitations and quality of life uh during the treatment period so you know what happens after 15 30 and 90 days
Of treatment so in terms of what we found for the first objective we saw that amped the flows and as compared with placebo significantly benefit patients in terms of a total political benefit against that hierarchical composite of death heartfelt events and change in cancer crime obstacle questionnaire to a similar extent regardless of the degree of symptomatic
Impairment at baseline and for the second objective we found that patients treated with example floating had significantly greater improvement in the symptoms as well as physical limitations and quality of life over time and importantly that benefit emerged already at 15 days and was sustained up to 90 days so very very quick onset of benefit and then consistent
Benefit over time right so as i mentioned earlier we have dearth of treatments in acute heart failure that have been proven to significantly uh improve symptoms physical limitations quality of life and this patient populations that’s really symptomatical and functionally impaired and i think the message from this data is that uh sglt2 inhibition for patients acutely
Hospitalized with heart failure is a treatment that won’t just potentially improve clinical events but also make patients feel better and be able uh enable them to be able to do more which is a critical uh goal of care in this patient population so yet another very important incentive to potentially think about initiating as jilted inhibitors in the hospital in
Patients with heart failure regardless of what type of heart failure they have whether it’s reduced or preserved ejection fraction whether it’s chronic decompensated or your normal heart failure because we saw the results on health status were very consistent across all of those subgroups well i think we already have a lot of data on agility to inhibition and heart
Failure all different types of heart failure but in the acute heart valley space there is more data coming i think importantly um so there are ongoing studies looking at dapagliflozin in acute decompensated heart failure uh i think that will further batterize the evidence space and then also very importantly we also have uh in heart failure with preserved ejection
Traction uh a second large outcome trial with topical flows and deliver which will be the largest trial of patients with half pathways the longest duration of follow-up so really will help hopefully solidify the evidence base for patients with heart failure and preserve the app which is really in need of additional therapies
Transcribed from video
ACC 22: Results from the EMPULSE Study – Empagliflozin Proves Beneficial for Patients with HF By Radcliffe
