P1876Empagliflozin reduces mortality in patients with type 2 diabetes and a history of left ventricular hypertrophy: a sub-analysis of the EMPA-REG OUTCOME trial
Bibliographic record
Abstract
Background: In patients with type 2 diabetes, left ventricular hypertrophy (LVH) is an established predictor of cardiovascular (CV) risk; whether glucose-lowering therapy reduces CV events in this high-risk group remains unknown. In the EMPA-REG OUTCOME trial, empagliflozin reduced the risk of 3-point MACE (composite of CV death, MI, or stroke) (primary outcome) by 14%, CV death by 38% and all-cause mortality by 35% vs placebo in patients with type 2 diabetes and established CV disease. In this post hoc analysis, we investigated the effects of empagliflozin on CV events and mortality in patients with ECG LVH. Methods: A total of 7020 patients with type 2 diabetes and established CV disease received study drug. Patients without a baseline ECG, an uninterpretable ECG, or who took study drug prior to baseline ECG were excluded from the analysis. Results: Of 5973 patients included in this analysis, 140 had ECG LVH at baseline. The incidence rate for CV death (per 1000 patient-years) was 78.9 vs 19.1 in placebo-treated patients with vs without LVH and 32.1 vs 11.6 in empagliflozin-treated patients with vs without LVH. The incidence rates for 3-point MACE and all-cause mortality were also approximately 4 times higher in those with than without LVH. Empagliflozin reduced CV events to a greater extent in patients with LVH at baseline. The hazard ratios (95% CI) for 3-point-MACE were 0.39 (0.19, 0.81) in patients with LVH vs 0.89 (0.76, 1.05) in those without LVH (p-value for interaction = 0.0295). The hazard ratios for CV death were 0.40 (0.16, 1.01) in patients with LVH vs 0.60 (0.47, 0.78) in patients without LVH (p-value for interaction = 0.4034). The hazard ratios for all-cause death were 0.32 (0.13, 0.78) in patients with LVH vs 0.67 (0.55, 0.83) in patients without LVH (p-value for interaction = 0.1126). The absolute risk reductions with empagliflozin vs placebo were greater because both the event rates and the relative risk reductions were higher in patients with vs without LVH.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".