{
  "abstract": "Background Kidney function decline in heart failure (HF) may accelerate during periods surrounding HF-related events, while sodium-glucose cotransporter 2 inhibitors slow kidney function decline. However, the temporal relationship between kidney function changes, HF-related events, and treatment effects has not been well characterized. Aims We aimed to explore kidney function trajectories around HF-related events and to assess whether empagliflozin modifies these changes. Methods and results In a pooled analysis of the EMPEROR-Reduced and EMPEROR-Preserved trials, we examined longitudinal changes in estimated glomerular filtration rate (eGFR) before and after HF-related events, defined as HF hospitalization or HF-related death. In the EMPEROR-Pooled analysis, HF-related events occurred in 12.7% of 9554 patients during a median follow-up of 20.9 months (14.7–28.6). Patients who experienced HF-related events had a steeper eGFR decline during the 12 months before the event than those without HF-related events: average −5.01 ml/min/1.73 m2/year vs −1.93 ml/min/1.73 m2/year; P < .001. During the 12 months after HF-related events, eGFR decline persisted at an average rate of −4.73 ml/min/1.73 m2/year. These trajectories were not materially altered after adjustment for concurrent NYHA class or natriuretic peptide levels. Compared with placebo, empagliflozin slowed eGFR decline in patients without events (between-group difference, 0.94 ml/min/1.73 m2/year) and before events (1.09 ml/min/1.73 m2/year). The post-event difference was smaller (0.29 ml/min/1.73 m2/year), without significant heterogeneity across periods (P > .10). Findings were consistent across trials and irrespective of prior HF hospitalization. Conclusion Across the LVEF spectrum, kidney function decline accelerated before HF-related events and remained rapid thereafter. Empagliflozin attenuated eGFR decline without evidence of heterogeneity across periods.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "name": "Masatake Kobayashi"
    },
    {
      "name": "Kévin Duarte"
    },
    {
      "name": "Guillaume Baudry"
    },
    {
      "name": "João Pedro Ferreira"
    },
    {
      "name": "Luca Monzo"
    },
    {
      "name": "Javed Butler"
    },
    {
      "name": "Faiez Zannad"
    },
    {
      "name": "Nicolas Girerd"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dc3nd4bgqt888.bib",
  "cited_by": 0,
  "doi": "10.1093/ejhf/xuag295",
  "fulltext_url": null,
  "id": "dc3nd4bgqt888",
  "issns": [
    "1388-9842"
  ],
  "landing_url": "https://hal.univ-lorraine.fr/hal-05789113v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "openalex",
      "2705|Heart Failure Treatment and Management"
    ]
  ],
  "openalex": "W7220715844",
  "pdf_url": "https://hal.univ-lorraine.fr/hal-05789113/document",
  "pmcid": null,
  "pmid": "42834642",
  "published": "2026-10-06",
  "publisher": "European Society of Cardiology (Wiley)",
  "ris": "https://research.draconitic.com/paper/dc3nd4bgqt888.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:52Z",
      "native_id": "hal-05789113",
      "source": "hal",
      "url": "https://hal.univ-lorraine.fr/hal-05789113v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Heart Failure Treatment and Management",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Kidney function decline, heart failure hospitalization, and the effect of empagliflozin in heart failure: an EMPEROR-pooled analysis",
  "title_text": "Kidney function decline, heart failure hospitalization, and the effect of empagliflozin in heart failure: an EMPEROR-pooled analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:52Z",
  "url": "https://research.draconitic.com/paper/dc3nd4bgqt888",
  "venue": "European Journal of Heart Failure",
  "versions": []
}