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Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF

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Harvard

Martinez, FA, Serenelli, M, Nicolau, JC, Petrie, MC, Chiang, C-E, Tereshchenko, S, Solomon, SD, Inzucchi, SE, Køber, L, Kosiborod, MN, Ponikowski, P, Sabatine, MS, Demets, DL, Dutkiewicz-Piasecka, M, Bengtsson, O, Sjöstrand, M, Langkilde, AM, Jhund, PS & McMurray, JJV 2020, 'Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF', Circulation, vol. 141, no. 2, pp. 100-111. https://doi.org/10.1161/CIRCULATIONAHA.119.044133

APA

Martinez, F. A., Serenelli, M., Nicolau, J. C., Petrie, M. C., Chiang, C-E., Tereshchenko, S., Solomon, S. D., Inzucchi, S. E., Køber, L., Kosiborod, M. N., Ponikowski, P., Sabatine, M. S., Demets, D. L., Dutkiewicz-Piasecka, M., Bengtsson, O., Sjöstrand, M., Langkilde, A. M., Jhund, P. S., & McMurray, J. J. V. (2020). Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF. Circulation, 141(2), 100-111. https://doi.org/10.1161/CIRCULATIONAHA.119.044133

CBE

Martinez FA, Serenelli M, Nicolau JC, Petrie MC, Chiang C-E, Tereshchenko S, Solomon SD, Inzucchi SE, Køber L, Kosiborod MN, Ponikowski P, Sabatine MS, Demets DL, Dutkiewicz-Piasecka M, Bengtsson O, Sjöstrand M, Langkilde AM, Jhund PS, McMurray JJV. 2020. Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF. Circulation. 141(2):100-111. https://doi.org/10.1161/CIRCULATIONAHA.119.044133

MLA

Vancouver

Author

Martinez, Felipe A ; Serenelli, Matteo ; Nicolau, Jose C ; Petrie, Mark C ; Chiang, Chern-En ; Tereshchenko, Sergey ; Solomon, Scott D ; Inzucchi, Silvio E ; Køber, Lars ; Kosiborod, Mikhail N ; Ponikowski, Piotr ; Sabatine, Marc S ; Demets, David L ; Dutkiewicz-Piasecka, Monika ; Bengtsson, Olof ; Sjöstrand, Mikaela ; Langkilde, Anna Maria ; Jhund, Pardeep S ; McMurray, John J V. / Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age : Insights From DAPA-HF. In: Circulation. 2020 ; Vol. 141, No. 2. pp. 100-111.

Bibtex

@article{264522d9a8ef4901aefe00eae560ca57,
title = "Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF",
abstract = "BACKGROUND: The DAPA-HF trial (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure) showed that dapagliflozin added to other guideline-recommended therapies reduced the risk of mortality and heart failure hospitalization and improved symptoms in patients with heart failure and reduced ejection fraction. We examined the effects of dapagliflozin according to age, given potential concerns about the efficacy and safety of therapies in the elderly.METHODS: Patients in New York Heart Association functional class II or greater with a left ventricular ejection fraction ≤40% and a modest elevation of NT-proBNP (N-terminal pro-B-type natriuretic peptide) were eligible. Key exclusion criteria included systolic blood pressure <95 mm Hg and estimated glomerular filtration rate <30 mL·min -1·1.73 m -2. The primary outcome was the composite of an episode of worsening heart failure (heart failure hospitalization or urgent heart failure visit) or cardiovascular death, whichever occurred first. RESULTS: A total of 4744 patients 22 to 94 years of age (mean age, 66.3 [SD 10.9] years) were randomized: 636 patients (13.4%) were <55 years of age, 1242 (26.2%) were 55 to 64 years of age, 1717 (36.2%) were 65 to 74 years of age, and 1149 (24.2%) were ≥75 years of age. The rate of the primary outcome (per 100 person-years, placebo arm) in each age group was 13.6 (95% CI, 10.4-17.9), 15.7 (95% CI, 13.2-18.7), 15.1 (95% CI, 13.1-17.5), and 18.0 (95% CI, 15.2-21.4) with corresponding dapagliflozin/placebo hazard ratios of 0.87 (95% CI, 0.60-1.28), 0.71 (95% CI, 0.55-0.93), 0.76 (95% CI, 0.61-0.95), and 0.68 (95% CI, 0.53-0.88; P for interaction=0.76). Consistent benefits were observed for the components of the primary outcome, all-cause mortality, and symptoms. Although adverse events and study drug discontinuation increased with age, neither was significantly more common with dapagliflozin in any age group. CONCLUSIONS: Dapagliflozin reduced the risk of death and worsening heart failure and improved symptoms across the broad spectrum of age studied in DAPA-HF. There was no significant imbalance in tolerability or safety events between dapagliflozin and placebo, even in elderly individuals.CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03036124.",
keywords = "age, dapagliflozin, heart failure, SGLT2 inhibitors",
author = "Martinez, {Felipe A} and Matteo Serenelli and Nicolau, {Jose C} and Petrie, {Mark C} and Chern-En Chiang and Sergey Tereshchenko and Solomon, {Scott D} and Inzucchi, {Silvio E} and Lars K{\o}ber and Kosiborod, {Mikhail N} and Piotr Ponikowski and Sabatine, {Marc S} and Demets, {David L} and Monika Dutkiewicz-Piasecka and Olof Bengtsson and Mikaela Sj{\"o}strand and Langkilde, {Anna Maria} and Jhund, {Pardeep S} and McMurray, {John J V}",
year = "2020",
month = jan,
day = "14",
doi = "10.1161/CIRCULATIONAHA.119.044133",
language = "English",
volume = "141",
pages = "100--111",
journal = "Circulation (Baltimore)",
issn = "0009-7322",
publisher = "Lippincott Williams & Wilkins",
number = "2",

}

RIS

TY - JOUR

T1 - Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age

T2 - Insights From DAPA-HF

AU - Martinez, Felipe A

AU - Serenelli, Matteo

AU - Nicolau, Jose C

AU - Petrie, Mark C

AU - Chiang, Chern-En

AU - Tereshchenko, Sergey

AU - Solomon, Scott D

AU - Inzucchi, Silvio E

AU - Køber, Lars

AU - Kosiborod, Mikhail N

AU - Ponikowski, Piotr

AU - Sabatine, Marc S

AU - Demets, David L

AU - Dutkiewicz-Piasecka, Monika

AU - Bengtsson, Olof

AU - Sjöstrand, Mikaela

AU - Langkilde, Anna Maria

AU - Jhund, Pardeep S

AU - McMurray, John J V

PY - 2020/1/14

Y1 - 2020/1/14

N2 - BACKGROUND: The DAPA-HF trial (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure) showed that dapagliflozin added to other guideline-recommended therapies reduced the risk of mortality and heart failure hospitalization and improved symptoms in patients with heart failure and reduced ejection fraction. We examined the effects of dapagliflozin according to age, given potential concerns about the efficacy and safety of therapies in the elderly.METHODS: Patients in New York Heart Association functional class II or greater with a left ventricular ejection fraction ≤40% and a modest elevation of NT-proBNP (N-terminal pro-B-type natriuretic peptide) were eligible. Key exclusion criteria included systolic blood pressure <95 mm Hg and estimated glomerular filtration rate <30 mL·min -1·1.73 m -2. The primary outcome was the composite of an episode of worsening heart failure (heart failure hospitalization or urgent heart failure visit) or cardiovascular death, whichever occurred first. RESULTS: A total of 4744 patients 22 to 94 years of age (mean age, 66.3 [SD 10.9] years) were randomized: 636 patients (13.4%) were <55 years of age, 1242 (26.2%) were 55 to 64 years of age, 1717 (36.2%) were 65 to 74 years of age, and 1149 (24.2%) were ≥75 years of age. The rate of the primary outcome (per 100 person-years, placebo arm) in each age group was 13.6 (95% CI, 10.4-17.9), 15.7 (95% CI, 13.2-18.7), 15.1 (95% CI, 13.1-17.5), and 18.0 (95% CI, 15.2-21.4) with corresponding dapagliflozin/placebo hazard ratios of 0.87 (95% CI, 0.60-1.28), 0.71 (95% CI, 0.55-0.93), 0.76 (95% CI, 0.61-0.95), and 0.68 (95% CI, 0.53-0.88; P for interaction=0.76). Consistent benefits were observed for the components of the primary outcome, all-cause mortality, and symptoms. Although adverse events and study drug discontinuation increased with age, neither was significantly more common with dapagliflozin in any age group. CONCLUSIONS: Dapagliflozin reduced the risk of death and worsening heart failure and improved symptoms across the broad spectrum of age studied in DAPA-HF. There was no significant imbalance in tolerability or safety events between dapagliflozin and placebo, even in elderly individuals.CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03036124.

AB - BACKGROUND: The DAPA-HF trial (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure) showed that dapagliflozin added to other guideline-recommended therapies reduced the risk of mortality and heart failure hospitalization and improved symptoms in patients with heart failure and reduced ejection fraction. We examined the effects of dapagliflozin according to age, given potential concerns about the efficacy and safety of therapies in the elderly.METHODS: Patients in New York Heart Association functional class II or greater with a left ventricular ejection fraction ≤40% and a modest elevation of NT-proBNP (N-terminal pro-B-type natriuretic peptide) were eligible. Key exclusion criteria included systolic blood pressure <95 mm Hg and estimated glomerular filtration rate <30 mL·min -1·1.73 m -2. The primary outcome was the composite of an episode of worsening heart failure (heart failure hospitalization or urgent heart failure visit) or cardiovascular death, whichever occurred first. RESULTS: A total of 4744 patients 22 to 94 years of age (mean age, 66.3 [SD 10.9] years) were randomized: 636 patients (13.4%) were <55 years of age, 1242 (26.2%) were 55 to 64 years of age, 1717 (36.2%) were 65 to 74 years of age, and 1149 (24.2%) were ≥75 years of age. The rate of the primary outcome (per 100 person-years, placebo arm) in each age group was 13.6 (95% CI, 10.4-17.9), 15.7 (95% CI, 13.2-18.7), 15.1 (95% CI, 13.1-17.5), and 18.0 (95% CI, 15.2-21.4) with corresponding dapagliflozin/placebo hazard ratios of 0.87 (95% CI, 0.60-1.28), 0.71 (95% CI, 0.55-0.93), 0.76 (95% CI, 0.61-0.95), and 0.68 (95% CI, 0.53-0.88; P for interaction=0.76). Consistent benefits were observed for the components of the primary outcome, all-cause mortality, and symptoms. Although adverse events and study drug discontinuation increased with age, neither was significantly more common with dapagliflozin in any age group. CONCLUSIONS: Dapagliflozin reduced the risk of death and worsening heart failure and improved symptoms across the broad spectrum of age studied in DAPA-HF. There was no significant imbalance in tolerability or safety events between dapagliflozin and placebo, even in elderly individuals.CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03036124.

KW - age

KW - dapagliflozin

KW - heart failure

KW - SGLT2 inhibitors

U2 - 10.1161/CIRCULATIONAHA.119.044133

DO - 10.1161/CIRCULATIONAHA.119.044133

M3 - Journal article

C2 - 31736328

VL - 141

SP - 100

EP - 111

JO - Circulation (Baltimore)

JF - Circulation (Baltimore)

SN - 0009-7322

IS - 2

ER -

ID: 58442191