Dapagliflozin when added to standard therapy improved symptoms and reduced the risk of worsening heart failure events and cardiovascular death in patients with heart failure and reduced ejection fraction (HFrEF), according to findings from the DAPA-HF study presented Sept. 1 at ESC Congress 2019. "The relative and absolute risk reductions in death and hospitalization were substantial, clinically important, and consistent across important subgroups, including patients without [type 2 diabetes]," said John J. V. McMurray, MD, FACC, who presented the results.

The trial screened 8,134 patients with HFrEF (both with and without T2D) from 20 countries in North America, Western Europe, Central/Eastern Europe, Latin America and the Asia Pacific region. Of those screened, 4,744 were randomized to receive either dapagliflozin (10 mg once daily) or placebo, added to standard therapy. The primary endpoint was worsening heart failure events or cardiovascular death. Median follow-up was 18.2 months.

Overall results showed reduced risks of cardiovascular death, heart failure hospitalizations and urgent heart failure visits with dapagliflozin compared with placebo. In addition, researchers noted a 2.8-point difference in improvement on the Kansas City Cardiomyopathy Questionnaire from baseline to eight months, with the dapagliflozin group coming out on top (+6.1 vs. +3.3).

According to McMurray and colleagues, dapagliflozin was well tolerated and the rate of treatment discontinuation was low, suggesting a new approach to the treatment of HFrEF.

Keywords: ESC 19, ESC Congress, Diabetes Mellitus, Type 2, Stroke Volume, Heart Failure, Hospitalization, Glucosides, Benzhydryl Compounds, Cardiomyopathies

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