Heart failure & cardiomyopathiesSecondary analysis
Achieved Ejection Fraction and Effects of Dapagliflozin in Heart Failure With Improved Ejection Fraction
- Secondary analysis of the DELIVER randomised trial
- subgroup analysis
Authors' conclusion
In patients with HFimpEF, the efficacy and safety of dapagliflozin in reducing cardiovascular death or worsening HF events were consistent irrespective of the degree of LVEF improvement before enrollment, including in those who achieve an LVEF ≥60% who appear to face significant residual risks of clinical events.
Study context
- Population
- Patients with HF with improved EF (heart failure with improved ejection fraction (HFimpEF)) in the DELIVER trial (HF and left ventricular ejection fraction (LVEF) >40%)HFimpEF of 6,263
- Participants
- 1,151 patients
- Comparison
- Dapagliflozin vs placebo, by achieved LVEF in HF with improved EF
- ≤49%n = 624reference
- 50%-59%n = 328
- ≥60%n = 199
- Primary endpoint
- Worsening HF or CV death
- Follow-up
- Median 2.3 years
Primary result
As reported in the abstract
Worsening HF or CV death, HFimpEF vs LVEF consistently >40%, by baseline LVEF
| Group | HFimpEF rate per 100 person-years | LVEF consistently >40% rate per 100 person-years |
|---|---|---|
| ≤49% | 9.9 | 10.5 |
| 50%-59% | 6.7 | 8.4 |
| ≥60% | 9.3 | 7.5 |
- Dapagliflozin safely and consistently reduced the risk of the primary outcome across LVEF groups
- P for interaction = 0.19
Original publication
Achieved Ejection Fraction and Effects of Dapagliflozin in Heart Failure With Improved Ejection Fraction. JACC Heart Fail. Published 19 August 2025. doi:10.1016/j.jchf.2025.102585
Summarised from the published abstract; every number is checked against it