{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T15:31:52Z","timestamp":1774452712588,"version":"3.50.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"13","license":[{"start":{"date-parts":[[2021,1,9]],"date-time":"2021-01-09T00:00:00Z","timestamp":1610150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Boehringer Ingelheim & Eli Lilly and Company Diabetes Alliance"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>In this secondary analysis of the EMPEROR-Reduced trial, we sought to evaluate whether the benefits of empagliflozin varied by baseline health status and how empagliflozin impacted patient-reported outcomes in patients with heart failure with reduced ejection fraction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Health status was assessed by the Kansas City Cardiomyopathy Questionnaires-clinical summary score (KCCQ-CSS). The influence of baseline KCCQ-CSS (analyzed by tertiles) on the effect of empagliflozin on major outcomes was examined using Cox proportional hazards models. Responder analyses were performed to assess the odds of improvement and deterioration in KCCQ scores related to treatment with empagliflozin. Empagliflozin reduced the primary outcome of cardiovascular death or heart failure hospitalization regardless of baseline KCCQ-CSS tertiles [hazard ratio (HR) 0.83 (0.68\u20131.02), HR 0.74 (0.58\u20130.94), and HR 0.61 (0.46\u20130.82) for &amp;lt;62.5, 62.6\u201385.4, and \u226585.4 score tertiles, respectively; P-trend\u2009=\u20090.10]. Empagliflozin improved KCCQ-CSS, total symptom score, and overall summary score at 3, 8, and 12\u2009months. More patients on empagliflozin had \u22655-point [odds ratio (OR) 1.20 (1.05\u20131.37)], 10-point [OR 1.26 (1.10\u20131.44)], and 15-point [OR 1.29 (1.12\u20131.48)] improvement and fewer had \u22655-point [OR 0.75 (0.64\u20130.87)] deterioration in KCCQ-CSS at 3\u2009months. These benefits were sustained at 8 and 12\u2009months and were similar for other KCCQ domains.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Empagliflozin improved cardiovascular death or heart failure hospitalization risk across the range of baseline health status. Empagliflozin improved health status across various domains, and this benefit was sustained during long-term follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trial registration<\/jats:title>\n                  <jats:p>URL: https:\/\/www.clinicaltrials.gov. Unique identifier: NCT03057977.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaa1007","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T20:11:47Z","timestamp":1606421507000},"page":"1203-1212","source":"Crossref","is-referenced-by-count":154,"title":["Empagliflozin and health-related quality of life outcomes in patients with heart failure with reduced ejection fraction: the EMPEROR-Reduced trial"],"prefix":"10.1093","volume":"42","author":[{"given":"Javed","family":"Butler","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Mississippi School of Medicine , Jackson, MS, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3331-7314","authenticated-orcid":false,"given":"Stefan D","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT) ; German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charit\u00e9 Universit\u00e4tsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0332","authenticated-orcid":false,"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, National and Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon , 2 Thivon Street, Athens 157 72, Greece"}]},{"given":"Muhammad Shahzeb","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Mississippi School of Medicine , Jackson, MS, USA"}]},{"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Physiology and Surgery, Cardiovascular R&D Unit, Institut Lorrain du Coeur et des Vaisseaux , 5 Rue du Morvan, 54500 Vandeuvre-l\u00e8s-Nancy, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2212-4007","authenticated-orcid":false,"given":"Stuart J","family":"Pocock","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, London School of Hygiene & Tropical Medicine , Keppel Street, London WCIE 7HT, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7173-8051","authenticated-orcid":false,"given":"Nadia","family":"Giannetti","sequence":"additional","affiliation":[{"name":"Division of Cardiology, McGill University Health Center , 1001 Decarie Blvd.Royal Victoria Hospital, D05.5115 Montreal, Quebec H4A 3J1, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8338-1798","authenticated-orcid":false,"given":"James L","family":"Januzzi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Harvard Medical School, Massachusetts General Hospital , 25 Shattuck St, Boston, MA 02115, USA"}]},{"given":"Ileana L","family":"Pi\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Medicine, Wayne State and Central Michigan Universities , 540 E. Canfield Ave, Detroit, MI 48201, USA"}]},{"given":"Carolyn S P","family":"Lam","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore & Duke-National University of Singapore , 8 College Rd, Singapore 169857, Singapore"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Centre for Heart Diseases, Wroclaw Medical University , Borowska 213, 50-556 Wroclaw, Poland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1604-2593","authenticated-orcid":false,"given":"Naveed","family":"Sattar","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Medical Sciences, University of Glasgow , BHF Glasgow Cardiovascular Research Centre (GCRC), 126 University Place, Glasgow G12 8TA, UK"}]},{"given":"Subodh","family":"Verma","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, St Michael\u2019s Hospital, University of Toronto , 30 Bond Street, Toronto, ON, M5B 1W8, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1215-0746","authenticated-orcid":false,"given":"Martina","family":"Brueckmann","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH , Binger Strasse 173 Ingelheim am Rhein, 55216, Germany"},{"name":"Faculty of Medicine Mannheim, University of Heidelberg , Ludolf-Krehl-Stra\u00dfe 13-17, 68167 Mannheim, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9133-8450","authenticated-orcid":false,"given":"Waheed","family":"Jamal","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH , Binger Strasse 173 Ingelheim am Rhein, 55216, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1618-0494","authenticated-orcid":false,"given":"Ola","family":"Vedin","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim AB , Hammarby all\u00e9 29, 120 32 Stockholm, Sweden"}]},{"given":"Barbara","family":"Peil","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim Pharma GmbH & Co. KG , Binger Strasse 173 Ingelheim am Rhein, 55216, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0639-8836","authenticated-orcid":false,"given":"Cordula","family":"Zeller","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim Pharma GmbH & Co. KG , Birkendorfer Str. 65, 88397 Biberach an der Ri\u00df, Germany"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Physiology and Surgery, Cardiovascular R&D Unit, Institut Lorrain du Coeur et des Vaisseaux , 5 Rue du Morvan, 54500 Vandeuvre-l\u00e8s-Nancy, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1828-2387","authenticated-orcid":false,"given":"Milton","family":"Packer","sequence":"additional","affiliation":[{"name":"Cardiovascular Science, Baylor Heart and Vascular Institute, Baylor University Medical Center , 621 N. Hall Street, Dallas, TX 75226, USA"},{"name":"Faculty of Medicine, National Heart and Lung Institute, Imperial College , Guy Scadding Building, Cale Street, SW3 6LY London, UK"}]},{"name":"the EMPEROR-Reduced Trial Committees and Investigators","sequence":"additional","affiliation":[]}],"member":"286","published-online":{"date-parts":[[2021,1,9]]},"reference":[{"key":"2022102514140628000_ehaa1007-B1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s11936-013-0249-2","article-title":"Assessing the impact of heart failure therapeutics on quality of life and functional capacity","volume":"15","author":"Lewis","year":"2013","journal-title":"Curr Treat Options Cardiovasc Med"},{"key":"2022102514140628000_ehaa1007-B2","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1007\/s11897-007-0037-y","article-title":"Assessment of quality of life in severe heart failure","volume":"4","author":"Vaishnava","year":"2007","journal-title":"Curr Heart Fail 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patients with heart failure and reduced ejection fraction: results from the DAPA-HF trial","volume":"141","author":"Kosiborod","year":"2020","journal-title":"Circulation"},{"key":"2022102514140628000_ehaa1007-B8","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1056\/NEJMoa2022190","article-title":"Cardiovascular and renal outcomes with empagliflozin in heart failure","volume":"383","author":"Packer","year":"2020","journal-title":"N Engl J Med"},{"key":"2022102514140628000_ehaa1007-B9","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1002\/ejhf.1536","article-title":"Evaluation of the effect of sodium-glucose co-transporter 2 inhibition with empagliflozin on morbidity and mortality of patients with chronic heart failure and a reduced ejection fraction: rationale for and design of the EMPEROR-Reduced trial","volume":"21","author":"Packer","year":"2019","journal-title":"Eur J Heart 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