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Scott David Solomon, John J.V. McMurray, Brian Lee Claggett, Rudolf A. de Boer, David L. DeMets, Adrian F. Hernandez, Silvio E. Inzucchi, Mikhail Kosiborod, Carolyn S.P. Lam, Felipe A. Martínez and 32 more
BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure and cardiovascular death among patients with chronic heart failure and a left ventricular ejection fraction of 40% or less. Whether SGLT2 inhibitors are effective in patients with a higher left ventricular ejection fraction remains less certain. METHODS: We randomly assigned 6263 patients with heart failure and a left ventricular ejection fraction of more than 40% to receive dapagliflozin (at a dose of 10 mg once daily) or matching placebo, in addition to usual therapy. The primary outcome was a composite of worsening heart failure (which was defined as either an unplanned hospitalization for heart failure or an urgent visit for heart failure) or cardiovascular death, as assessed in a time-to-event analysis. RESULTS: Over a median of 2.3 years, the primary outcome occurred in 512 of 3131 patients (16.4%) in the dapagliflozin group and in 610 of 3132 patients (19.5%) in the placebo group (hazard ratio, 0.82; 95% confidence interval [CI], 0.73 to 0.92; P<0.001). Worsening heart failure occurred in 368 patients (11.8%) in the dapagliflozin group and in 455 patients (14.5%) in the placebo group (hazard ratio, 0.79; 95% CI, 0.69 to 0.91); cardiovascular death occurred in 231 patients (7.4%) and 261 patients (8.3%), respectively (hazard ratio, 0.88; 95% CI, 0.74 to 1.05). Total events and symptom burden were lower in the dapagliflozin group than in the placebo group. Results were similar among patients with a left ventricular ejection fraction of 60% or more and those with a left ventricular ejection fraction of less than 60%, and results were similar in prespecified subgroups, including patients with or without diabetes. The incidence of adverse events was similar in the two groups. CONCLUSIONS: Dapagliflozin reduced the combined risk of worsening heart failure or cardiovascular death among patients with heart failure and a mildly reduced or preserved ejection fraction. (Funded by AstraZeneca; DELIVER ClinicalTrials.gov number, NCT03619213.).
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Solomon, S. D., McMurray, J. J., Claggett, B. L., Boer, R. A. D., DeMets, D. L., Hernandez, A. F., Inzucchi, S. E., Kosiborod, M., Lam, C. S., Martínez, F. A., Shah, S. J., Desai, A. S., Jhund, P. S., Bělohlávek, J., Chiang, C., Borleffs, C. J. W., Colet, J. C., Dobreanu, D., Dróżdż, J., … Langkilde, A. M. (2022). Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. New England Journal of Medicine, 387(12), 1089–1098. https://doi.org/10.1056/nejmoa2206286
Solomon, Scott David, et al. "Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction." New England Journal of Medicine, vol. 387, no. 12, 2022, pp. 1089–1098, https://doi.org/10.1056/nejmoa2206286.
Solomon, Scott David, John J.V. McMurray, Brian Lee Claggett, Rudolf A. de Boer, David L. DeMets, Adrian F. Hernandez, Silvio E. Inzucchi, et al. "Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction." New England Journal of Medicine 387, no. 12 (2022): 1089–1098. https://doi.org/10.1056/nejmoa2206286.
Solomon S. D., McMurray J. J., Claggett B. L. [и др.] Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction // New England Journal of Medicine. — 2022. — Vol. 387, № 12. — P. 1089–1098. — URL: https://doi.org/10.1056/nejmoa2206286
@article{solomon2022dapagliflozin,
title = {{Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction}},
author = {Scott David Solomon and John J.V. McMurray and Brian Lee Claggett and Rudolf A. de Boer and David L. DeMets and Adrian F. Hernandez and Silvio E. Inzucchi and Mikhail Kosiborod and Carolyn S.P. Lam and Felipe A. Martínez and Sanjiv Jayendra Shah and Akshay Suvas Desai and Pardeep S. Jhund and Jan Bělohlávek and Chern‐En Chiang and C. Jan Willem Borleffs and Josep Comin Colet and Dan Dobreanu and Jarosław Dróżdż and James Chen-Tson Fang and Marco Antonio Alcocer-Gamba and Waleed Al Habeeb and Yaling Han and Jose Walter Cabrera Honorio and Stefan P. Janssens and Tzvetana Katova and Masafumi Kitakaze and Béla Péter Merkely and Eileen O’Meara and José Francisco Kerr Saraiva and Sergey N. Tereshchenko and Jorge Mario Thierer and Muthiah Vaduganathan and Orly Vardeny and Subodh Verma and Vinh Nguyen Pham and Ulrica Wilderäng and Natalia Zaozerska and Erasmus Bachus and Daniel P. Lindholm and Magnus Petersson and Anna Maria Langkilde},
journal = {New England Journal of Medicine},
year = {2022},
volume = {387},
number = {12},
pages = {1089--1098},
doi = {10.1056/nejmoa2206286},
url = {https://doi.org/10.1056/nejmoa2206286}
}TY - JOUR AU - Solomon, Scott David AU - McMurray, John J.V. AU - Claggett, Brian Lee AU - Boer, Rudolf A. de AU - DeMets, David L. AU - Hernandez, Adrian F. AU - Inzucchi, Silvio E. AU - Kosiborod, Mikhail AU - Lam, Carolyn S.P. AU - Martínez, Felipe A. AU - Shah, Sanjiv Jayendra AU - Desai, Akshay Suvas AU - Jhund, Pardeep S. AU - Bělohlávek, Jan AU - Chiang, Chern‐En AU - Borleffs, C. Jan Willem AU - Colet, Josep Comin AU - Dobreanu, Dan AU - Dróżdż, Jarosław AU - Fang, James Chen-Tson AU - Alcocer-Gamba, Marco Antonio AU - Habeeb, Waleed Al AU - Han, Yaling AU - Honorio, Jose Walter Cabrera AU - Janssens, Stefan P. AU - Katova, Tzvetana AU - Kitakaze, Masafumi AU - Merkely, Béla Péter AU - O’Meara, Eileen AU - Saraiva, José Francisco Kerr AU - Tereshchenko, Sergey N. AU - Thierer, Jorge Mario AU - Vaduganathan, Muthiah AU - Vardeny, Orly AU - Verma, Subodh AU - Pham, Vinh Nguyen AU - Wilderäng, Ulrica AU - Zaozerska, Natalia AU - Bachus, Erasmus AU - Lindholm, Daniel P. AU - Petersson, Magnus AU - Langkilde, Anna Maria TI - Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction JO - New England Journal of Medicine VL - 387 IS - 12 SP - 1089 EP - 1098 PY - 2022 DA - 2022/08/27 DO - 10.1056/nejmoa2206286 UR - https://doi.org/10.1056/nejmoa2206286 ER -
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