Dapagliflozin reduces the dangers of demise and cardiovascular occasions in sufferers with coronary heart failure no matter ejection fraction, in keeping with late-breaking analysis introduced in a Scorching Line session at this time at ESC Congress 2022.
This pre-specified patient-level meta-analysis mixed the DAPA-HF and DELIVER trials of the SGLT2 inhibitor dapagliflozin in sufferers with coronary heart failure. DAPA-HF enrolled sufferers with decreased ejection fraction (40% or much less) and DELIVER enrolled sufferers with mildly decreased and preserved ejection fraction (above 40%). Each trials randomly allotted contributors to dapagliflozin 10 mg as soon as day by day or placebo.
The primary purpose of this evaluation was to look at the impact of dapagliflozin on plenty of secondary outcomes that every trial alone was not powered to look at. The second purpose was to look at if dapagliflozin was efficient throughout the complete vary of ejection fraction, because the EMPEROR-Preserved trial beforehand recommended that the impact of empagliflozin, one other SGLT2 inhibitor, could also be attenuated in sufferers with greater ejection fraction.
A complete of 11,007 sufferers have been randomised to dapagliflozin or placebo within the two trials. Survival evaluation was used to look at the impact of dapagliflozin on demise from cardiovascular causes; demise from any trigger; whole hospital admissions for coronary heart failure; and the composite of demise from cardiovascular causes, myocardial infarction, or stroke (main antagonistic cardiovascular occasions; MACE).
The common age of contributors was 69 years and 35% have been ladies. The median observe up was 1.8 years. Dapagliflozin decreased the chance of demise from cardiovascular causes by 14% (hazard ratio [HR] 0.86; 95% confidence interval [CI] 0.76-0.97; p=0.01), demise from any trigger by 10% (HR 0.90; 95% CI 0.82-0.99; p=0.03), whole hospital admissions for coronary heart failure by 29% (relative danger [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 proof that the impact of dapagliflozin differed by ejection fraction for any of the outcomes.
Our findings affirm that every one sufferers with coronary heart failure, no matter ejection fraction, could profit from dapagliflozin along with another coronary heart failure remedy they’re receiving.”
Pardeep Jhund, Research Creator, Professor College of Glasgow, UK
