{"id":"9310db10f07c","type":"article","url":"https://hartvaat.nl/2026/03/05/empathy-hartfalentherapie-bij-patienten-met-gevorderde-kanker-en-palliatieve-zor/","title":"EMPATHY: hartfalentherapie bij patiënten met gevorderde kanker en palliatieve zorg","title_en":"Heart failure therapy in patients with advanced cancer receiving specialized palliative care (EMPATICC trial).","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","pathfinder-trial","step-hfpef"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaf705","source_url":"https://doi.org/10.1093/eurheartj/ehaf705","authors":["Markus S Anker","Amir A Mahabadi","Matthias Totzeck","Mitra Tewes","Muhammad Shahzeb Khan","Raluca I Mincu","Ulrike B Hendgen-Cotta","Lars Michel","Baicy Mathew","Ophelia Drescher","Martin Schuler","Ulrich Keller","Kathrin Rieger","Johann Ahn","Lars Bullinger","Dominik P Modest","Corinna Denecke","Lucie Kretzler","Luisa V Ramer","Danara Krug","Ulf Landmesser","Lorenz H Lehmann","Norbert Frey","Sven Bercker","Ulrich Laufs","Michael Böhm","Felix Mahfoud","Bela Merkely","Monika Diek","Javed Butler","Anja Veiser","Tim Heise","Martin Hellmich","Marius Placzek","Tim Friede","Stefan D Anker","Tienush Rassaf"],"significance":6,"published":"2026-03-05","source_date":"2026-03-05","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/palliatief-hartfalen/","https://hartvaat.nl/kennis/hartfalen/icd-bij-hartfalen/"],"congress":"","summary_en":"The EMPATICC trial examined heart failure therapy in patients with advanced cancer receiving palliative care, showing that optimizing HF treatment improves symptoms and function even in the end-of-life setting.","created":"2026-07-03T10:32:13Z","updated":"2026-07-03T18:39:20Z","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":"De EMPATHY-trial onderzocht hartfalentherapie bij patiënten met gevorderde kanker onder palliatieve zorg. Optimale HF-behandeling verbeterde de kwaliteit van leven ook in deze populatie.","abstract_original":"BACKGROUND AND AIMS: Advanced cancer may resemble a heart failure (HF)-like phenotype marked by cardiac wasting, dyspnoea, congestion, and/or physical dysfunction. The trial evaluated safety and efficacy of HF therapy among patients with advanced cancer receiving specialized palliative care to improve patients' self-care ability. METHODS: Patients with stage 4 solid tumours with a life expectancy of 1-6 months receiving specialized palliative care were enrolled. Patients were required to meet at least two cardiovascular risk criteria and at least one criterion for functional limitation. Participants were randomized 1:1 to receive optimized HF therapy (up to four drugs: sacubitril/valsartan, empagliflozin, ivabradine, ferric carboxymaltose) or placebo in a double-blind setting. The primary hierarchical endpoint included: (i) days alive and able to wash oneself, (ii) ability to walk 4 m, and (iii) self-reported patient global assessment (PGA) of subjective well-being, during the 30-day placebo-controlled phase. RESULTS: In five centres, 93 patients were randomized. The primary endpoint did not differ between groups (win ratio 0.95, 95% confidence interval [CI] 0.57-1.58; P = .83). Overall, mortality was 32% at 30 days (not different between groups). In patients alive at 30 days, HF therapy reduced N-terminal pro-B-type natriuretic peptide levels by 41% (P = .040), increased left ventricular ejection fraction by 2.9% (P = .036), and improved PGA scores (odds ratio 0.22, 95% CI 0.06-0.75; P = .016). CONCLUSIONS: In a population with advanced cancer receiving specialized palliative care and high early mortality, optimized HF therapy did not improve patients' self-care ability. Among survivors at 30 days, improvements in quality of life measures and cardiac biomarkers suggest potential benefit of individualized HF therapy, which is hypothesis generating and needs validation."}