Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction

Jawad H Butt; Kieran F Docherty; Mikhail N Kosiborod; Silvio E Inzucchi; Lars Køber; Anna Maria Langkilde; Felipe A Martinez; Olof Bengtsson; Piotr Ponikowski; Marc S Sabatine; Mikaela Sjöstrand; Scott Solomon; Pardeep S Jhund; John J V McMurray

doi:10.1016/j.jchf.2023.04.016

Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction

Jawad H Butt, Kieran F Docherty, Mikhail N Kosiborod, Silvio E Inzucchi, Lars Køber, Anna Maria Langkilde, Felipe A Martinez, Olof Bengtsson, Piotr Ponikowski, Marc S Sabatine, Mikaela Sjöstrand, Scott Solomon, Pardeep S Jhund, John J V McMurray^*

^*Corresponding author for this work

Department of Cardiology

4 Citations (Scopus)

Abstract

BACKGROUND: Heart failure (HF) is associated with impaired physical function and poor quality of life and affects health status more profoundly than many other chronic diseases.

OBJECTIVES: The authors examined the effects of dapagliflozin on specific physical and social limitations as reported by patients in the DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) trial.

METHODS: The effect of dapagliflozin on the change from baseline to 8 months in each of the individual physical and social activity limitation questions answered by patients completing the Kansas City Cardiomyopathy Questionnaire (KCCQ), and overall scores, were examined with mixed-effects models and responder analyses.

RESULTS: In total, 4,269 (90.0%) and 3,955 (83.4%) patients had complete data for both the physical and social activity limitation scores at baseline and 8 months, respectively. Compared with placebo, dapagliflozin significantly increased (improved) the mean KCCQ physical and social activity limitation scores at 8 months (placebo-corrected mean difference 1.94 [95% CI: 0.73-3.16] and 1.84 [95% CI: 0.43-3.25], respectively). Dapagliflozin also increased each of the individual components that comprise the physical and social activity limitations domains at 8 months, with the largest improvement seen in "hobbies or recreational activities" (placebo-corrected mean difference: 2.76 [95% CI: 1.06-4.46]) and "doing yardwork, housework, or carrying groceries" (placebo-corrected mean difference: 2.59 [95% CI: 0.76-4.42]). The proportion of patients with a 5-point improvement from baseline to 8 months in the KCCQ physical and social activity limitation scores was greater with dapagliflozin than with placebo (ORs: 1.23 [95% CI: 1.09-1.40] and 1.19 [95% CI: 1.05-1.35], respectively).

CONCLUSIONS: In patients with HFrEF, dapagliflozin, compared with placebo, improved physical and social activity limitations as measured by KCCQ. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients with Chronic Heart Failure [DAPA-HF]; NCT03036124).

Original language	English
Journal	JACC. Heart failure
Volume	11
Issue number	10
Pages (from-to)	1411-1423
Number of pages	13
ISSN	2213-1779
DOIs	https://doi.org/10.1016/j.jchf.2023.04.016
Publication status	Published - Oct 2023

Keywords

Heart Failure
Humans
Quality of Life
Stroke Volume
Ventricular Dysfunction, Left/complications
heart failure
dapagliflozin
randomized trial
quality of life

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10.1016/j.jchf.2023.04.016

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Butt, J. H., Docherty, K. F., Kosiborod, M. N., Inzucchi, S. E., Køber, L., Langkilde, A. M., Martinez, F. A., Bengtsson, O., Ponikowski, P., Sabatine, M. S., Sjöstrand, M., Solomon, S., Jhund, P. S., & McMurray, J. J. V. (2023). Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction. JACC. Heart failure, 11(10), 1411-1423. https://doi.org/10.1016/j.jchf.2023.04.016

Butt, JH, Docherty, KF, Kosiborod, MN, Inzucchi, SE, Køber, L, Langkilde, AM, Martinez, FA, Bengtsson, O, Ponikowski, P, Sabatine, MS, Sjöstrand, M, Solomon, S, Jhund, PS & McMurray, JJV 2023, 'Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction', JACC. Heart failure, vol. 11, no. 10, pp. 1411-1423. https://doi.org/10.1016/j.jchf.2023.04.016

@article{d5419eafb9844a45a268c4d735bd438f,

title = "Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction",

abstract = "BACKGROUND: Heart failure (HF) is associated with impaired physical function and poor quality of life and affects health status more profoundly than many other chronic diseases.OBJECTIVES: The authors examined the effects of dapagliflozin on specific physical and social limitations as reported by patients in the DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) trial.METHODS: The effect of dapagliflozin on the change from baseline to 8 months in each of the individual physical and social activity limitation questions answered by patients completing the Kansas City Cardiomyopathy Questionnaire (KCCQ), and overall scores, were examined with mixed-effects models and responder analyses.RESULTS: In total, 4,269 (90.0%) and 3,955 (83.4%) patients had complete data for both the physical and social activity limitation scores at baseline and 8 months, respectively. Compared with placebo, dapagliflozin significantly increased (improved) the mean KCCQ physical and social activity limitation scores at 8 months (placebo-corrected mean difference 1.94 [95% CI: 0.73-3.16] and 1.84 [95% CI: 0.43-3.25], respectively). Dapagliflozin also increased each of the individual components that comprise the physical and social activity limitations domains at 8 months, with the largest improvement seen in {"}hobbies or recreational activities{"} (placebo-corrected mean difference: 2.76 [95% CI: 1.06-4.46]) and {"}doing yardwork, housework, or carrying groceries{"} (placebo-corrected mean difference: 2.59 [95% CI: 0.76-4.42]). The proportion of patients with a 5-point improvement from baseline to 8 months in the KCCQ physical and social activity limitation scores was greater with dapagliflozin than with placebo (ORs: 1.23 [95% CI: 1.09-1.40] and 1.19 [95% CI: 1.05-1.35], respectively).CONCLUSIONS: In patients with HFrEF, dapagliflozin, compared with placebo, improved physical and social activity limitations as measured by KCCQ. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients with Chronic Heart Failure [DAPA-HF]; NCT03036124).",

keywords = "Heart Failure, Humans, Quality of Life, Stroke Volume, Ventricular Dysfunction, Left/complications, heart failure, dapagliflozin, randomized trial, quality of life",

author = "Butt, {Jawad H} and Docherty, {Kieran F} and Kosiborod, {Mikhail N} and Inzucchi, {Silvio E} and Lars K{\o}ber and Langkilde, {Anna Maria} and Martinez, {Felipe A} and Olof Bengtsson and Piotr Ponikowski and Sabatine, {Marc S} and Mikaela Sj{\"o}strand and Scott Solomon and Jhund, {Pardeep S} and McMurray, {John J V}",

year = "2023",

month = oct,

doi = "10.1016/j.jchf.2023.04.016",

language = "English",

volume = "11",

pages = "1411--1423",

journal = "JACC. Heart failure",

issn = "2213-1779",

publisher = "Elsevier BV",

number = "10",

}

TY - JOUR

T1 - Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction

AU - Butt, Jawad H

AU - Docherty, Kieran F

AU - Kosiborod, Mikhail N

AU - Inzucchi, Silvio E

AU - Køber, Lars

AU - Langkilde, Anna Maria

AU - Martinez, Felipe A

AU - Bengtsson, Olof

AU - Ponikowski, Piotr

AU - Sabatine, Marc S

AU - Sjöstrand, Mikaela

AU - Solomon, Scott

AU - Jhund, Pardeep S

AU - McMurray, John J V

PY - 2023/10

Y1 - 2023/10

N2 - BACKGROUND: Heart failure (HF) is associated with impaired physical function and poor quality of life and affects health status more profoundly than many other chronic diseases.OBJECTIVES: The authors examined the effects of dapagliflozin on specific physical and social limitations as reported by patients in the DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) trial.METHODS: The effect of dapagliflozin on the change from baseline to 8 months in each of the individual physical and social activity limitation questions answered by patients completing the Kansas City Cardiomyopathy Questionnaire (KCCQ), and overall scores, were examined with mixed-effects models and responder analyses.RESULTS: In total, 4,269 (90.0%) and 3,955 (83.4%) patients had complete data for both the physical and social activity limitation scores at baseline and 8 months, respectively. Compared with placebo, dapagliflozin significantly increased (improved) the mean KCCQ physical and social activity limitation scores at 8 months (placebo-corrected mean difference 1.94 [95% CI: 0.73-3.16] and 1.84 [95% CI: 0.43-3.25], respectively). Dapagliflozin also increased each of the individual components that comprise the physical and social activity limitations domains at 8 months, with the largest improvement seen in "hobbies or recreational activities" (placebo-corrected mean difference: 2.76 [95% CI: 1.06-4.46]) and "doing yardwork, housework, or carrying groceries" (placebo-corrected mean difference: 2.59 [95% CI: 0.76-4.42]). The proportion of patients with a 5-point improvement from baseline to 8 months in the KCCQ physical and social activity limitation scores was greater with dapagliflozin than with placebo (ORs: 1.23 [95% CI: 1.09-1.40] and 1.19 [95% CI: 1.05-1.35], respectively).CONCLUSIONS: In patients with HFrEF, dapagliflozin, compared with placebo, improved physical and social activity limitations as measured by KCCQ. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients with Chronic Heart Failure [DAPA-HF]; NCT03036124).

AB - BACKGROUND: Heart failure (HF) is associated with impaired physical function and poor quality of life and affects health status more profoundly than many other chronic diseases.OBJECTIVES: The authors examined the effects of dapagliflozin on specific physical and social limitations as reported by patients in the DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) trial.METHODS: The effect of dapagliflozin on the change from baseline to 8 months in each of the individual physical and social activity limitation questions answered by patients completing the Kansas City Cardiomyopathy Questionnaire (KCCQ), and overall scores, were examined with mixed-effects models and responder analyses.RESULTS: In total, 4,269 (90.0%) and 3,955 (83.4%) patients had complete data for both the physical and social activity limitation scores at baseline and 8 months, respectively. Compared with placebo, dapagliflozin significantly increased (improved) the mean KCCQ physical and social activity limitation scores at 8 months (placebo-corrected mean difference 1.94 [95% CI: 0.73-3.16] and 1.84 [95% CI: 0.43-3.25], respectively). Dapagliflozin also increased each of the individual components that comprise the physical and social activity limitations domains at 8 months, with the largest improvement seen in "hobbies or recreational activities" (placebo-corrected mean difference: 2.76 [95% CI: 1.06-4.46]) and "doing yardwork, housework, or carrying groceries" (placebo-corrected mean difference: 2.59 [95% CI: 0.76-4.42]). The proportion of patients with a 5-point improvement from baseline to 8 months in the KCCQ physical and social activity limitation scores was greater with dapagliflozin than with placebo (ORs: 1.23 [95% CI: 1.09-1.40] and 1.19 [95% CI: 1.05-1.35], respectively).CONCLUSIONS: In patients with HFrEF, dapagliflozin, compared with placebo, improved physical and social activity limitations as measured by KCCQ. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients with Chronic Heart Failure [DAPA-HF]; NCT03036124).

KW - Heart Failure

KW - Humans

KW - Quality of Life

KW - Stroke Volume

KW - Ventricular Dysfunction, Left/complications

KW - heart failure

KW - dapagliflozin

KW - randomized trial

KW - quality of life

UR - http://www.scopus.com/inward/record.url?scp=85169896840&partnerID=8YFLogxK

U2 - 10.1016/j.jchf.2023.04.016

DO - 10.1016/j.jchf.2023.04.016

M3 - Journal article

C2 - 37318419

SN - 2213-1779

VL - 11

SP - 1411

EP - 1423

JO - JACC. Heart failure

JF - JACC. Heart failure

IS - 10

ER -

Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction

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