NPPB and heart failure: In contrast, although empagliflozin led to no change in NT-proBNP levels in the EMPERIAL-Reduced (Empagliflozin outcome trial In patients with chronic heart failure with reduced ejection fraction)11 or EMPERIAL-Preserved trials (Empagliflozin outcome trial In patients with chronic heart failure with preserved ejection fraction),12 both the phase III EMPEROR-reduced13 and EMPEROR-preserved14 clinical trials showed significant improvements in the primary endpoint of cardiovascular death and heart failure hospitalization.