Key result
Dapagliflozin reduced the risk of cardiovascular death or worsening heart failure (HR 0.74) compared to placebo in patients with heart failure with reduced ejection fraction, regardless of type 2 diabetes status.
Why the study?
Patients with HFrEF have a high residual risk of adverse outcomes despite optimal evidence-based treatment, motivating evaluation of dapagliflozin effectiveness.
Does dapagliflozin improve hard endpoints in patients with HFrEF regardless of type 2 diabetes status?
Does dapagliflozin improve hard endpoints in patients with HFrEF regardless of type 2 diabetes status?
Hazard Ratio: 0.74 (95% CI 0.65–0.85)
Absolute Risk Reduction: 4.9%
Dapagliflozin demonstrates effectiveness in HFrEF patients regardless of diabetes status, supporting its inclusion in guideline-directed medical therapy.
Patients with heart failure with reduced ejection fraction (HFrEF), despite optimal evidence-based treatment, have a high residual risk of adverse outcomes. The favorable results of studies on cardiovascular safety and the effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with type 2 diabetes (T2D), including outcomes associated with heart failure, were the reason for studying the effectiveness in patients with HFrEF regardless of the T2D status. For the first time in the DAPA-HF study, the SGLT2 inhibitor dapagliflozin in patients with HFrEF showed a positive effect on hard endpoints. Data of the secondary analysis confirmed the effectiveness of dapagliflozin regardless of the T2D status, therapy, age, and quality of life. The results of DAPA-HF have become a serious statement for changing the standards of the guideline-recommended therapy of HFrEF.
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Medovchshikov et al. (2020) conducted a review in Heart failure with reduced ejection fraction (HFrEF) (n=4,744). Dapagliflozin vs. Placebo was evaluated on Composite of cardiovascular death, hospitalization for heart failure, or urgent heart failure visit (HR 0.74, 95% CI 0.65-0.85). Dapagliflozin reduced the risk of cardiovascular death or worsening heart failure (HR 0.74) compared to placebo in patients with heart failure with reduced ejection fraction, regardless of type 2 diabetes status.
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