Understanding the mechanisms mediating cardio-renal benefit of empagliflozin in type 2 diabetes mellitus

Abstract

In a recently published, post-hoc analysis of the hallmark EMPA-REG OUTCOME trial, Kramer ¨ et al.1 assessed whether changes in cardiac and haemodynamic markers achieved with empagliflozin in subjects with type 2 diabetes mellitus (T2DM) may mediate its significant benefits across a number of surrogate cardiovascular and kidney outcomes. They have demonstrated1 that empagliflozin treatment resulted in a significant decrease in pulse pressure (PP), mean arterial pressure (MAP) and cardiac workload, compared with placebo; at week 12, placebo-adjusted mean changes from baseline were − 2.5 mmHg for PP, − 2.2 mmHg for MAP and − 315 mmHg x beats per minute (bpm) for cardiac workload (p < 0.0001 for all). They have also found that such benefits were present for both empagliflozin groups (10 mg and 25 mg) combined, while treatment differences were maintained throughout to week 164.