Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction

. 2019 Nov 21 ; 381 (21) : 1995-2008. [epub] 20190919

Jazyk angličtina Země Spojené státy americké Médium print-electronic

Typ dokumentu klinické zkoušky, fáze III, časopisecké články, multicentrická studie, randomizované kontrolované studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid31535829

BACKGROUND: In patients with type 2 diabetes, inhibitors of sodium-glucose cotransporter 2 (SGLT2) reduce the risk of a first hospitalization for heart failure, possibly through glucose-independent mechanisms. More data are needed regarding the effects of SGLT2 inhibitors in patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes. METHODS: In this phase 3, placebo-controlled trial, we randomly assigned 4744 patients with New York Heart Association class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either dapagliflozin (at a dose of 10 mg once daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of worsening heart failure (hospitalization or an urgent visit resulting in intravenous therapy for heart failure) or cardiovascular death. RESULTS: Over a median of 18.2 months, the primary outcome occurred in 386 of 2373 patients (16.3%) in the dapagliflozin group and in 502 of 2371 patients (21.2%) in the placebo group (hazard ratio, 0.74; 95% confidence interval [CI], 0.65 to 0.85; P<0.001). A first worsening heart failure event occurred in 237 patients (10.0%) in the dapagliflozin group and in 326 patients (13.7%) in the placebo group (hazard ratio, 0.70; 95% CI, 0.59 to 0.83). Death from cardiovascular causes occurred in 227 patients (9.6%) in the dapagliflozin group and in 273 patients (11.5%) in the placebo group (hazard ratio, 0.82; 95% CI, 0.69 to 0.98); 276 patients (11.6%) and 329 patients (13.9%), respectively, died from any cause (hazard ratio, 0.83; 95% CI, 0.71 to 0.97). Findings in patients with diabetes were similar to those in patients without diabetes. The frequency of adverse events related to volume depletion, renal dysfunction, and hypoglycemia did not differ between treatment groups. CONCLUSIONS: Among patients with heart failure and a reduced ejection fraction, the risk of worsening heart failure or death from cardiovascular causes was lower among those who received dapagliflozin than among those who received placebo, regardless of the presence or absence of diabetes. (Funded by AstraZeneca; DAPA-HF ClinicalTrials.gov number, NCT03036124.).

Komentář v

PubMed

Komentář v

PubMed

Komentář v

PubMed

Komentář v

PubMed

Komentář v

PubMed

Komentář v

PubMed

Komentář v

PubMed

Citace poskytuje Crossref.org

Nejnovějších 20 citací...

Zobrazit více v
Medvik | PubMed

Pediatric Chronic Heart Failure: Age-Specific Considerations of Medical Therapy

. 2024 Nov 29 ; 73 (S2) : S597-S613.

Metabolic Consequences of Advanced Chronic Heart Failure and its Modification by Implantation of a Durable Left Ventricular Assist Device

. 2024 Nov ; 25 (11) : 388. [epub] 20241031

Heart failure care in the Central and Eastern Europe and Baltic region: status, barriers, and routes to improvement

. 2024 Aug ; 11 (4) : 1861-1874. [epub] 20240322

Effect of Sodium-Glucose Co-Transporter-2 Inhibitor on Estimated Plasma Volume in a Patient With Heart Failure With Reduced Ejection Fraction and a Patient With Heart Failure With Preserved Ejection Fraction

. 2024 Jul ; 47 (7) : e24303.

Sodium-glucose cotransporter 2 inhibitors induce anti-inflammatory and anti-ferroptotic shift in epicardial adipose tissue of subjects with severe heart failure

. 2024 Jun 28 ; 23 (1) : 223. [epub] 20240628

CVOT Summit Report 2023: new cardiovascular, kidney, and metabolic outcomes

. 2024 Mar 19 ; 23 (1) : 104. [epub] 20240319

Pharmacotherapy of diabetes mellitus in patients with heart failure - a nation-wide analysis of contemporary treatment

. 2023 Jun ; 167 (2) : 177-184. [epub] 20211208

Left ventricular electrical potential measured by the NOGA XP electromechanical mapping method as a predictor of response to cardiac resynchronization therapy

. 2023 ; 10 () : 1107415. [epub] 20230504

Left ventricular reverse remodelling and its predictors in non-ischaemic cardiomyopathy

. 2022 Aug ; 9 (4) : 2070-2083. [epub] 20220418

Metformin treatment is associated with improved outcome in patients with diabetes and advanced heart failure (HFrEF)

. 2022 Jul 29 ; 12 (1) : 13038. [epub] 20220729

Sodium Glucose Cotransporter-2 Inhibitors: Spotlight on Favorable Effects on Clinical Outcomes beyond Diabetes

. 2022 Mar 04 ; 23 (5) : . [epub] 20220304

The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial

. 2022 Mar ; 28 (3) : 568-574. [epub] 20220228

DCRM Multispecialty Practice Recommendations for the management of diabetes, cardiorenal, and metabolic diseases

. 2022 Feb ; 36 (2) : 108101. [epub] 20211207

Efficacy of dapagliflozin in heart failure with reduced ejection fraction according to body mass index

. 2021 Oct ; 23 (10) : 1662-1672. [epub] 20210729

The efficacy and safety of dapagliflozin in women and men with type 2 diabetes mellitus

. 2021 Jun ; 64 (6) : 1226-1234. [epub] 20210220

The effect of three major co-morbidities on quality of life and outcome of patients with heart failure with reduced ejection fraction

. 2021 Apr ; 8 (2) : 1417-1426. [epub] 20210129

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction: GALACTIC-HF baseline characteristics and comparison with contemporary clinical trials

. 2020 Nov ; 22 (11) : 2160-2171. [epub] 20201027

Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes

. 2020 Oct 23 ; 19 (1) : 185. [epub] 20201023

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

. 2020 Sep 15 ; 142 (11) : 1040-1054. [epub] 20200716

Effect of Dapagliflozin on Worsening Heart Failure and Cardiovascular Death in Patients With Heart Failure With and Without Diabetes

. 2020 Apr 14 ; 323 (14) : 1353-1368.

Zobrazit více v PubMed

ClinicalTrials.gov
NCT03036124

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...