The influence of Empagliflozin on NT-proBNP and blood pressure in type 2 diabetes patients: a retrospective analysis

Objectives:

Empagliflozin is known to reduce cardiovascular events in type 2 diabetes patients, the mechanisms underlying this effect are not completely understood. To date there is no data available on the effects of empagliflozin on markers of myocardial function. This study evaluates possible influences of empagliflozin on NT-proBNP serum levels as a strong biomarker for the development of heart failure in type 2 diabetes.

Methods:

A retrospective analysis of type 2 diabetes outpatients started on empagliflozin for the first time was performed. Subjects were included in the analysis, when NT-proBNP measurements were available before and after the initiation of treatment. NT-proBNP values, as well as HBA1c and blood pressure before and after the initiation of treatment were compared using a dependent t-test.

Results:

The database search identified 31 subjects with a poor glycemic control (HBA1c 9.3 ± 1.3%). As expected, after a mean of 121 days of treatment there were significant improvements in HbA1c (0.8%, p = 0.01) and blood pressure by a mean of 5 mmHG diastolic (p = 0.01) and 6 mmHg systolic (p = 0.06). Yet, no significant effects on NT-proBNP could be observed in 23 patients with NT-proBNP values above the detection threshold before treatment (266 ± 313 vs. 243 ± 268 pg/ml, p = 0.53).

Conclusions:

The results fall in line with recent data available for canagliflozin, which showed rather a stabilization than a decrease of NT-proBNP values over 104 weeks compared to placebo. Larger controlled and prospective studies will be needed to substantiate this finding and help decipher pathophysiological benefits of SGLT-2 inhibitors on cardiac function and metabolism.