Effectiveness of Empagliflozin in Patients with Heart Failure Having Type-2 Diabetes

Abstract

Introduction: Heart failure with reduced ejection fraction (HFrEF) is a significant cause of morbidity and mortality in patients with diabetes mellitus type 2 (T2DM). Although international trials have shown the cardiovascular benefits of empagliflozin, there is limited local data for the effectiveness of empagliflozin in Pakistani patients. This research intended to compare the effectiveness of empagliflozin versus placebo, as well as standard medical therapy, in patients with T2DM and HFrEF.

Methods: This randomized, double-blind, placebo-controlled trial was conducted at Allama Iqbal Memorial Teaching Hospital, Sialkot, from June to December 2025. A total of 170 patients aged 20–75 years with T2DM and LVEF <50% were enrolled and randomized (1:1) to receive empagliflozin 10 mg/day or matching placebo along with guideline-directed medical therapy. Echocardiographic assessment was performed at baseline and after 3 months. Effectiveness was defined as improvement in left ventricular ejection fraction (LVEF) to ≥50%. Data were analyzed using SPSS v27.0, with p ≤0.05 considered significant.

Results: Baseline characteristics were comparable between groups. Treatment efficacy was achieved in 78.8% of patients receiving empagliflozin versus 54.1% in the placebo group (p=0.001).

Conclusion: In addition, empagliflozin significantly improved left ventricular function when compared to placebo in patients with T2DM and HFrEF when added to standard therapy. These findings support its usefulness in improving cardiac outcomes in this high-risk population.