EASD Congress 2025 - Dr Camilla Andersen (The University of Western Australia, Perth, AU) joins us to discuss findings from the EMPIRE-PREVENT: Metabolic study, investigating the metabolic effects of empagliflozin in elderly and obese patients at high risk of developing heart failure (HF).

This randomized controlled trial evaluated 165 patients aged 60–84 years with obesity (BMI >28kg/m²) and established cardiovascular risk factors, but without diabetes or existing heart failure. Participants were randomized to receive empagliflozin 10mg daily or placebo for 180 days. The study utilized advanced imaging techniques including cardiac MRI and isotope clearance studies to assess changes in epicardial adipose tissue volume and extracellular volume - key parameters in heart failure development. Secondary endpoints examined broader metabolic effects including body composition, glucose tolerance, and renal function.

Investigators found that after 180 days of treatment with empagliflozin, it significantly reduced estimated extracellular volume, with an estimated treatment difference of 123 ml compared to placebo. In contrast, investigators found no effect on ventricular epicardial adipose tissue in these patients.

Interview Questions:

What is the importance of this research?
Can you walk us through the study design and patient population?
What were your key findings?
What are the clinical implications of these findings for heart failure prevention strategies in high-risk populations?
How might these results influence future guidelines for empagliflozin use beyond its current diabetes and heart failure indications?

Recorded on-site at EASD Congress 2025.
Editors: Jordan Rance, Yazmin Sadik, Mirjam Boros.
Videographer: David Ben-Harosh
Support: This is an independent interview produced by Radcliffe Cardiology.