Heart failure & cardiomyopathies

A hierarchical kidney outcome using win statistics in patients with heart failure from the DAPA-HF and DELIVER trials

Nat MedPublished Post hoc analysis of the DAPA-HF and DELIVER randomised trials

Authors' conclusion

For this outcome, the win ratio was 1.10 (95% confidence interval (CI) = 1.06-1.15) in the combined dataset, 1.08 (95% CI = 1.01-1.16) in the DAPA-HF trial and 1.12 (95% CI = 1.05-1.18) in the DELIVER trial; that is, dapagliflozin was superior to placebo in both trials.

Study context

Population
Patients with HF with reduced (DAPA-HF) or mildly reduced or preserved EF (DELIVER)
Comparison
Dapagliflozin vs placebo
Primary endpoint
Hierarchical composite kidney outcome:
  1. All-cause mortality
  2. End-stage kidney disease
  3. Estimated glomerular filtration rate (eGFR) decline ≥57%
  4. eGFR decline ≥50%
  5. eGFR decline ≥40%
  6. Participant-level eGFR slope
Methodological detailswin statistics
  • Win statistics

Primary result

As reported in the abstract

Hierarchical composite kidney outcome
Dapagliflozin vs PlaceboWin ratio (95% CI)
Combined dataset
1.10(1.06–1.15)
DAPA-HF
1.08(1.01–1.16)
DELIVER
1.12(1.05–1.18)

Further findings

Hierarchical kidney outcome, by baseline kidney disease and T2DM (subgroups)

Benefits consistent with and without baseline kidney disease, and with and without T2DM

Original publication

A hierarchical kidney outcome using win statistics in patients with heart failure from the DAPA-HF and DELIVER trials. Nat Med. Published 6 May 2024. doi:10.1038/s41591-024-02941-8

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