Key result
Expanding dapagliflozin use in HFrEF is projected to prevent ~5,465 CV deaths in Russia.
Why the study?
To assess the effect of dapagliflozin therapy in patients with heart failure with reduced ejection fraction on state cardiovascular mortality target indicators.
Does expanding dapagliflozin therapy reduce population-level cardiovascular mortality in Russian patients with HFrEF?
Does expanding dapagliflozin therapy reduce population-level cardiovascular mortality in Russian patients with HFrEF?
Expanding dapagliflozin use by 10% annually in Russian HFrEF patients could prevent over 5,400 cardiovascular deaths by the third year, significantly contributing to national mortality reduction targets.
Projects CV mortality target gains with dapagliflozin in Russian HFrEF; leaves open need for local outcome trials before practice change.
Aim. To assess the effect of therapy with sodium glucose co-transporter type 2 inhibitor dapagliflozin in patients with heart failure with reduced ejection fraction (CHrEF) on the state cardiovascular mortality target indicators. Material and methods. All adult Russian patients with NYHA class II-IV HFrEF (left ventricular ejection fraction ≤40%) were considered as the target population. The characteristics of patients in the study corresponded to those in the Russian Hospital HF Registry (RUS-HFR). The study suggests that the use of dapagliflozin in addition to standard therapy will be expanded by 10% of the patient population annually in 2022-24. Cardiovascular mortality modeling was performed based on the extrapolation of DAPA-HF study result. The number of deaths that can be prevented was calculated when using dapagliflozin in addition to standard therapy. Further, the contribution of prevented deaths with dapagliflozin therapy to the achievement of federal and regional cardiovascular mortality target indicators (1, 2 and 3 years) was calculated. Results. The use of dapagliflozin in addition to standard therapy for patients with NYHA class II-IV CHrEF with the expansion of dapagliflozin therapy by 10% of the patient population annually will additionally prevent 1729 cardiovascular death in the first year. This will ensure the implementation of cardiovascular mortality target indicators in Russia in 2022 by 11,8%. In the second year, 3769 cardiovascular deaths will be prevented, which will ensure the implementation of target indicators in 2023 by 17,2%. In the third year, 5465 cardiovascular deaths prevented, which will ensure the implementation of implementation of target indicators in 2024 by 18,7%. Conclusion. The use of dapagliflozin in addition to standard therapy for patients with NYHA class II-IV CHrEF will ensure the implementation of implementation of target indicators in 2024 by 18,7%.
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Журавлева et al. (2021) studied Heart failure with reduced ejection fraction (HFrEF). Dapagliflozin vs. Standard therapy was evaluated on Cardiovascular deaths prevented. Expanding dapagliflozin use by 10% annually in Russian patients with HFrEF is projected to prevent 5,465 cardiovascular deaths over 3 years, achieving 18.7% of the national mortality target.
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