A 58-year-old man with type 2 diabetes and established cardiovascular disease is started on empagliflozin. The EMPA-REG OUTCOME trial demonstrated that its cardiovascular benefit is primarily driven by reduction in which outcome?
- A Non-fatal myocardial infarction
- B Non-fatal stroke
- C Cardiovascular death due to coronary events
- D Hospitalization for heart failure ✓
Explanation
The EMPA-REG OUTCOME trial showed empagliflozin significantly reduced cardiovascular death and hospitalization for heart failure in high-risk type 2 diabetics; the dominant driver was a 35% reduction in hospitalization for heart failure rather than reduction in atherosclerotic events (MI or stroke). This effect is attributed to SGLT2-inhibitor–induced reduction in preload/afterload, natriuresis, and anti-fibrotic myocardial effects rather than glucose-lowering per se. Subsequent EMPEROR-Reduced and DAPA-HF trials confirmed class-wide heart failure benefit even in non-diabetic patients.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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