Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Effect of Dapagliflozin in Patients With HFrEF Treated With Sacubitril/Valsartan: The DAPA-HF Trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Effects of Dapagliflozin in Patients With Kidney Disease, With and Without Heart Failure

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Hemodynamic Determinants of Activity Measured by Accelerometer in Patients With Stable Heart Failure

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Prognostic Value of Peak Oxygen Uptake in Patients Supported With Left Ventricular Assist Devices (PRO-VAD)

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Mineralocorticoid receptor antagonist improves cardiac structure in Type 2 Diabetes: Data from the MIRAD Trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Myocardial Infarction in Heart Failure With Preserved Ejection Fraction: Pooled Analysis of 3 Clinical Trials

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Scott D Solomon
  • Pardeep S Jhund
  • Brian L Claggett
  • Pooja Dewan
  • Lars Køber
  • Mikhail N Kosiborod
  • Felipe A Martinez
  • Piotr Ponikowski
  • Marc S Sabatine
  • Silvio E Inzucchi
  • Akshay S Desai
  • Olof Bengtsson
  • Daniel Lindholm
  • Mikaela Sjostrand
  • Anna Maria Langkilde
  • John J V McMurray
Vis graf over relationer

OBJECTIVES: This study assessed the efficacy and safety of dapagliflozin in patients who were or were not taking sacubitril/valsartan at baseline in the DAPA-HF (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients With Chronic Heart Failure) trial.

BACKGROUND: Both the angiotensin receptor neprilysin-inhibitor sacubitril/valsartan and the sodium glucose co-transporter 2 inhibitor dapagliflozin reduced cardiovascular death and heart failure (HF) hospitalization in patients with HF with reduced ejection fraction (HFrEF). Whether either of these classes of drugs influences the effectiveness or safety of the other remains unknown.

METHODS: DAPA-HF was a 4,744 patient trial that compared dapagliflozin with placebo in patients with HFrEF. Patients were analyzed according to whether they were taking sacubitril/valsartan at randomization. The efficacy of dapagliflozin on the primary composite outcome (CV death or episode of worsening heart failure), its components, and all-cause death was examined according to sacubitril/valsartan and the interaction tested. Predefined safety outcomes were examined by sacubitril/valsartan group.

RESULTS: A total of 508 patients (10.7%) enrolled in DAPA-HF were treated with sacubitril/valsartan at baseline. Patients prescribed sacubitril/valsartan were more likely to be from North America or Europe, to have lower ejection fractions and systolic and diastolic blood pressures, but were similar with respect to age, New York Heart Association functional class, history of diabetes, and use of other evidence-based HF therapies. The benefit of dapagliflozin compared with placebo was similar in patients taking sacubitril/valsartan (hazard ratio: 0.75; 95% confidence interval 0.50 to 1.13) compared with those not taking sacubitril/valsartan (hazard ratio: 0.74; 95% confidence interval 0.65 to 0.86) for the primary endpoint of cardiovascular death or worsening HF; similar findings were observed for secondary endpoints. All measures of safety, including episodes related to hypovolemia, were similar among patients randomized to dapagliflozin or placebo, whether they received background sacubitril/valsartan.

CONCLUSIONS: Dapagliflozin was similarly efficacious and safe in patients who were and who were not taking sacubitril/valsartan in the DAPA-HF trial, which suggested that the use of both agents together could further lower morbidity and mortality in patients with HFrEF. (Dapagliflozin And Prevention of Adverse outcomes in Heart Failure [DAPA-HF]; NCT03036124).

OriginalsprogEngelsk
TidsskriftJACC. Heart failure
Vol/bind8
Udgave nummer10
Sider (fra-til)811-818
Antal sider8
ISSN2213-1779
DOI
StatusUdgivet - okt. 2020

Bibliografisk note

Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

ID: 62248351