{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T20:01:44Z","timestamp":1777060904102,"version":"3.51.4"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T00:00:00Z","timestamp":1666051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Boehringer Ingelheim and Eli Lilly"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Effective and safe decongestion remains a major goal for optimal management of patients with acute heart failure (AHF). The effects of the sodium\u2013glucose cotransporter 2 inhibitor empagliflozin on decongestion-related endpoints in the EMPULSE trial (NCT0415775) were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A total of 530 patients hospitalized for AHF were randomized 1:1 to either empagliflozin 10\u2005mg once daily or placebo for 90 days. The outcomes investigated were: weight loss (WL), WL adjusted for mean daily loop diuretic dose (WL-adjusted), area under the curve of change from baseline in N-terminal pro-B-type natriuretic peptide levels, hemoconcentration, and clinical congestion score after 15, 30, and 90 days of treatment. Compared with placebo, patients treated with empagliflozin demonstrated significantly greater reductions in all studied markers of decongestion at all time-points, adjusted mean differences (95% confidence interval) at Days 15, 30, and 90 were: for WL \u22121.97 (\u22122.86, \u22121.08), \u22121.74 (\u22122.73, \u22120.74); \u22121.53 (\u22122.75, \u22120.31) kg; for WL-adjusted: \u22122.31 (\u22123.77, \u22120.85), \u22122.79 (\u22125.03, \u22120.54), \u22123.18 (\u22126.08, \u22120.28) kg\/40\u2005mg furosemide i.v. or equivalent; respectively (all P &amp;lt; 0.05). Greater WL at Day 15 (i.e. above the median WL in the entire population) was associated with significantly higher probability for clinical benefit at Day 90 (hierarchical composite of all-cause death, heart failure events, and a 5-point or greater difference in Kansas City Cardiomyopathy Questionnaire total symptom score change from baseline to 90 days) with the win ratio of 1.75 (95% confidence interval 1.37, 2.23; P &amp;lt; 0.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Initiation of empagliflozin in patients hospitalized for AHF resulted in an early, effective and sustained decongestion which was associated with clinical benefit at Day 90.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehac530","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T08:37:10Z","timestamp":1666082230000},"page":"41-50","source":"Crossref","is-referenced-by-count":190,"title":["Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9977-7722","authenticated-orcid":false,"given":"Jan","family":"Biegus","sequence":"first","affiliation":[{"name":"Institute of Heart Diseases, Wroclaw Medical University , ul. Borowska 213, Wroclaw 50-556 , Poland"}]},{"given":"Adriaan A","family":"Voors","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , Hanzeplein 1, P.O Box 30001, 9700 RB Groningen, HPC AB 31 , The Netherlands"}]},{"given":"Sean P","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Vanderbilt University Medical Center , Nashville, TN , USA"},{"name":"Geriatric Research and Education Clinical Care, Tennessee Valley Healthcare Facility VA Medical Center , Nashville, TN , USA"}]},{"given":"Mikhail N","family":"Kosiborod","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City , Kansas City, MO , USA"},{"name":"The George Institute for Global Health and the University of New South Wales , Sydney, New South Wales , Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9527-0852","authenticated-orcid":false,"given":"John R","family":"Teerlink","sequence":"additional","affiliation":[{"name":"Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco , 4150 Clement Street San Francisco, CA 94121 , USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7491-7637","authenticated-orcid":false,"given":"Christiane E","family":"Angermann","sequence":"additional","affiliation":[{"name":"Comprehensive Heart Failure Center W\u00fcrzburg, University and University Hospital W\u00fcrzburg, and Department of Medicine 1, University Hospital W\u00fcrzburg , Am Schwarzenberg 15, Haus A15 97078 W\u00fcrzburg , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-0713","authenticated-orcid":false,"given":"Jasper","family":"Tromp","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore, the National University Health System , Singapore; 12 Science Drive 2, #10-01, Singapore 117549"}]},{"given":"Joao Pedro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, Inserm, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) , Nancy , France"},{"name":"UnIC@RISE, Department of Surgery and Physiology, Cardiovascular Research and Development Center, University of Porto , Porto , Portugal"}]},{"given":"Michael E","family":"Nassif","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute and the University of Missouri , Kansas City, MO , USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7571-9886","authenticated-orcid":false,"given":"Mitchell A","family":"Psotka","sequence":"additional","affiliation":[{"name":"Inova Heart and Vascular Institute, Falls Church, VA, 3300 Gallows Road Falls Church , Virginia 22042 , USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1215-0746","authenticated-orcid":false,"given":"Martina","family":"Brueckmann","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH, Binger Stra\u00dfe 173 , 55216 Ingelheim am Rhein , Germany"},{"name":"First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg , Theodor-Kutzer-Ufer 1-3, 68167 Mannheim , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2763-0486","authenticated-orcid":false,"given":"Afshin","family":"Salsali","sequence":"additional","affiliation":[{"name":"Novo Nordisk pharmaceutical company, Vandt\u00e5rnsvej 110, 2860 S\u00f8borg , Copenhagen , Denmark"},{"name":"Faculty of Medicine, Rutgers University , New Brunswick, NJ, 125 Paterson street, New Brunswick, NJ 08901 , USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9354-9657","authenticated-orcid":false,"given":"Jonathan P","family":"Blatchford","sequence":"additional","affiliation":[{"name":"Elderbrook Solutions GmbH , Sky Tower, Borsigstr. 4, D-74321 Bietigheim-Bissingen , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3391-7064","authenticated-orcid":false,"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Institute of Heart Diseases, Wroclaw Medical University , ul. 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