Research shows the benefit of dapagliflozin for patients with heart failure regardless of ejection fraction

Research shows the benefit of dapagliflozin for patients with heart failure regardless of ejection fraction

Dapagliflozin reduces the risk of death and cardiovascular events in patients with heart failure regardless of ejection fraction, according to latest research presented today in a hotline session at the ESC Congress 2022.

This prespecified patient-level meta-analysis combined the DAPA-HF and DELIVER trials of the SGLT2 inhibitor dapagliflozin in patients with heart failure. DAPA-HF registered patients with reduced ejection fraction (40% or less) and DELIVER registered patients with slightly reduced and preserved ejection fraction (above 40%). Both studies randomly assigned participants to 10 mg of dapagliflozin or placebo once daily.

The first aim of this analysis was to examine the effect of dapagliflozin on a series of secondary endpoints that not each study was powered to examine on its own. The second aim was to investigate whether dapagliflozin was effective across the entire ejection fraction range, as the EMPEROR-Preserved study previously suggested that the effect of empagliflozin, another SGLT2 inhibitor, may be attenuated in patients with a higher ejection fraction.

A total of 11,007 patients were randomly assigned to dapagliflozin or placebo in the two studies. Survival analysis was used to examine the effect of dapagliflozin on death from cardiovascular causes; death from any cause; total number of heart failure hospitalizations; and the combination of death from cardiovascular causes, myocardial infarction or stroke (major adverse cardiovascular events; MACE).

The average age of participants was 69 years and 35% were women. The median follow-up time was 1.8 years. Dapagliflozin reduced the risk of death from cardiovascular causes by 14% (hazard ratio [HR] 0.86; 95% confidence interval [CI] 0.76-0.97; p = 0.01), death from any cause by 10% (HR 0.90; 95% CI 0.82-0.99; p = 0.03), total number of hospitalizations Heart failure by 29% (relative risk [RR] 0.71; 95% CI 0.65-0.78; p < 0.001) and MACE by 11% (HR 0.90; 95% CI 0.81-1.00; p = 0.045). There was no evidence that the effect of dapagliflozin differed by ejection fraction for any of the outcomes.

Our results confirm that all patients with heart failure, regardless of ejection fraction, can benefit from dapagliflozin in addition to any other heart failure therapy they receive.”

Pardeep Jhund, study author, Professor University of Glasgow, UK

Source:

European Society of Cardiology (ESC)

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