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This Week in Cardiology
Heart Failure · Week of Apr 7, 2026
Paper 1 of 5
NEJM Randomized Controlled Trial · 5,221 patients
Empagliflozin versus placebo in heart failure with mildly reduced ejection fraction: a multinational RCT
Why it matters
HFmrEF remains undertreated — this is the first large RCT to show benefit of SGLT2i specifically in this ejection fraction range.
Key finding
Empagliflozin reduced CV death or worsening HF by 21% (HR 0.79, 95% CI 0.69–0.90). NNT of 18 over 26 months.
Limitation
Open-label design; 68% male, predominantly European and North American cohort. Generalizability to broader populations unclear.
For your practice
Supports adding empagliflozin to guideline-directed therapy for HFmrEF patients — particularly those with comorbid diabetes or CKD.
Abstract (NEJM) Full text — open access Save for later
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