Dapagliflozin and Diuretic Use in Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF.

Circulation
Alice M JacksonJohn J V McMurray

Abstract

In the DAPA-HF trial (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure), the sodium-glucose cotransporter 2 inhibitor dapagliflozin reduced the risk of worsening heart failure and death in patients with heart failure and reduced ejection fraction. We examined the efficacy and tolerability of dapagliflozin in relation to background diuretic treatment and change in diuretic therapy after randomization to dapagliflozin or placebo. We examined the effects of study treatment in the following subgroups: no diuretic and diuretic dose equivalent to furosemide <40, 40, and >40 mg daily at baseline. We examined the primary composite end point of cardiovascular death or a worsening heart failure event and its components, all-cause death and symptoms. Of 4616 analyzable patients, 736 (15.9%) were on no diuretic, 1311 (28.4%) were on <40 mg, 1365 (29.6%) were on 40 mg, and 1204 (26.1%) were taking >40 mg. Compared with placebo, dapagliflozin reduced the risk of the primary end point across each of these subgroups: hazard ratios were 0.57 (95% CI, 0.36-0.92), 0.83 (95% CI, 0.63-1.10), 0.77 (95% CI, 0.60-0.99), and 0.78 (95% CI, 0.63-0.97), respectively (P for interaction=0.61). The hazard ratio in patients taking any diureti...Continue Reading

References

Oct 20, 2004·Circulation·James B YoungUNKNOWN Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) Investigators and Committees
Dec 31, 2008·Diabetes Care·James F ListFred T Fiedorek
Nov 16, 2010·The New England Journal of Medicine·Faiez ZannadUNKNOWN EMPHASIS-HF Study Group
May 15, 2013·Diabetes, Obesity & Metabolism·H J Lambers HeerspinkJ List
Apr 3, 2014·TheScientificWorldJournal·Yanggan WangXun Ai
Sep 2, 2014·The New England Journal of Medicine·John J V McMurrayUNKNOWN PARADIGM-HF Investigators and Committees
Oct 13, 2017·Diabetes, Obesity & Metabolism·Karen M HallowDavid W Boulton
Aug 31, 2018·American Heart Journal·Marat FudimRobert J Mentz
Sep 1, 2018·European Journal of Heart Failure·J M Ter Maaten, K Damman
Jan 5, 2019·JACC. Heart Failure·Hans-Peter Brunner-La RoccaUNKNOWN CHECK-HF Investigators
Feb 12, 2019·European Journal of Heart Failure·Orly VardenyScott D Solomon
Jul 17, 2019·European Journal of Heart Failure·John J V McMurrayUNKNOWN DAPA-HF Committees and Investigators
Sep 20, 2019·The New England Journal of Medicine·John J V McMurrayUNKNOWN DAPA-HF Trial Committees and Investigators
Feb 12, 2020·The Journal of Clinical Endocrinology and Metabolism·Husam GhanimParesh Dandona
Feb 23, 2020·European Journal of Heart Failure·Kevin DammanPeter van der Meer
Jul 13, 2020·JACC. Heart Failure·Scott D SolomonJohn J V McMurray

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Citations

Oct 6, 2020·Future Cardiology·Sara Sotirakos
Dec 1, 2020·European Journal of Heart Failure·Eva M BoorsmaAdriaan A Voors
Oct 22, 2020·Circulation·Milton PackerUNKNOWN EMPEROR-Reduced Trial Committees and Investigators
Oct 28, 2020·International Journal of Molecular Sciences·Yi-Chou HouKuo-Cheng Lu
Mar 7, 2021·Heart Failure Clinics·Sara Doimo, Daniela Pavan
Mar 20, 2021·Journal of the American College of Cardiology·Milton PackerUNKNOWN EMPEROR-Reduced Trial Committees and Investigators
Mar 20, 2021·Journal of the American College of Cardiology·Mikhail N Kosiborod, Muthiah Vaduganathan
Feb 23, 2021·European Journal of Heart Failure·Kieran F DochertyUNKNOWN DAPA-HF Investigators and Committees
Mar 27, 2021·Current Opinion in Nephrology and Hypertension·Caitlyn VlasschaertSamuel A Silver
May 9, 2021·European Journal of Heart Failure·Chris J KapeliosLars H Lund
Jun 1, 2021·ESC Heart Failure·Fredrika SchillSofia Enhörning
Jun 8, 2021·Heart Failure Reviews·Michele CorrealeSavina Nodari
Jun 16, 2021·Heart·Kieran F Docherty, Mark C Petrie
May 28, 2021·European Journal of Clinical Investigation·Massimo IacovielloEdoardo Gronda
Jul 16, 2021·European Heart Journal. Cardiovascular Pharmacotherapy·Jose S Aguilar-GallardoJohanna P Contreras
Aug 28, 2021·European Heart Journal·Theresa A McDonaghUNKNOWN ESC Scientific Document Group
Sep 1, 2021·Herz·Jan WintrichMichael Böhm
Oct 16, 2021·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Hannah A Blair

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