In the DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure) trial reported by McMurray et al. (Nov. 21 issue),1 among patients with heart failure and a reduced ejection fraction, the risk of worsening heart failure or death from cardiovascular causes was significantly lower among those who received dapagliflozin than among those who received placebo, regardless of the presence or absence of diabetes. These data present a new perspective for the care of patients with heart failure. However, the trial did not address the potential role of a change in uric acid levels as a mediator of the improvement in cardiovascular outcomes in the enrolled patients.
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