{"id":"0e883f5ed505","type":"article","url":"https://hartvaat.nl/2021/09/28/nt-probnp-prognose-en-empagliflozine-effect-bij-emperor-reduced/","title":"NT-proBNP prognose en empagliflozine-effect bij EMPEROR-Reduced","title_en":"Prognostic Importance of NT-proBNP and Effect of Empagliflozin in the EMPEROR-Reduced Trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["emperor-trials","nt-probnp"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2021.07.046","source_url":"https://doi.org/10.1016/j.jacc.2021.07.046","authors":["James L Januzzi","Faiez Zannad","Stefan D Anker","Javed Butler","Gerasimos Filippatos","Stuart J Pocock","João Pedro Ferreira","Naveed Sattar","Subodh Verma","Ola Vedin","Janet Schnee","Tomoko Iwata","Dan Cotton","Milton Packer"],"significance":6,"published":"2021-09-28","source_date":"2021-09-28","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/bnp-en-nt-probnp/"],"congress":"","summary_en":"This EMPEROR-Reduced analysis showed that baseline NT-proBNP levels have prognostic value and that empagliflozin reduces heart failure events consistently across the natriuretic peptide spectrum.","created":"2026-07-03T10:29:23Z","updated":"2026-07-03T13:28:31Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"EMPEROR-Reduced analyse naar de prognostische waarde van NT-proBNP en het effect van empagliflozine.","abstract_original":"BACKGROUND: The relationship between the benefits of empagliflozin in heart failure with reduced ejection fraction (HFrEF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) has not been reported. OBJECTIVES: The authors sought to evaluate the relationship between NT-proBNP and empagliflozin effects in EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction). METHODS: Patients with HFrEF were randomly assigned to placebo or empagliflozin 10 mg daily. NT-proBNP was measured at baseline, 4 weeks, 12 weeks, 52 weeks, and 100 weeks. Patients were divided into quartiles of baseline NT-proBNP. RESULTS: Incidence rates for each study outcome were 4- to 6-fold higher among those in the highest versus lowest NT-proBNP quartiles (≥3,480 vs <1,115 pg/mL). Study participants with higher NT-proBNP had 2- to 3-fold total hospitalizations higher than the lowest NT-proBNP quartile. Empagliflozin reduced risk for major cardiorenal events without heterogeneity across NT-proBNP quartiles (primary endpoint Pinteraction = 0.94; renal composite endpoint Pinteraction = 0.71). Empagliflozin treatment significantly reduced NT-proBNP at all timepoints examined; by 52 weeks, the adjusted mean difference from placebo was 13% (P < 0.001). An NT-proBNP in the lowest quartile (<1,115 pg/mL) 12 weeks after randomization was associated with lower risk for subsequent cardiovascular death or heart failure hospitalization regardless of baseline concentration. Treatment with empagliflozin resulted in 27% higher adjusted odds of an NT-proBNP concentration of <1,115 pg/mL by 12 weeks compared with placebo (P = 0.01). CONCLUSIONS: In EMPEROR-Reduced, higher baseline NT-proBNP concentrations were associated with greater risk for adverse heart failure or renal outcomes, but empagliflozin reduced risk regardless of baseline NT-proBNP concentration. The NT-proBNP concentration after treatment with empagliflozin better informs subsequent prognosis than pretreatment concentrations. (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction [EMPEROR-Reduced]; NCT03057977)."}