Heart failure & cardiomyopathies

Association of Dapagliflozin vs Placebo With Individual Kansas City Cardiomyopathy Questionnaire Components in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Secondary Analysis of the DELIVER Trial

JAMA CardiolPublished Secondary analysis of the DELIVER randomised trial

Authors' conclusion

In this study of patients with HF with mildly reduced or preserved ejection fraction, dapagliflozin was associated with improvement in a broad range of individual KCCQ components, with the greatest benefits in domains related to symptom frequency and physical limitations.

Study context

Population
Symptomatic heart failure (HF) with LVEF >40%, elevated natriuretic peptides and structural heart disease5,795 with baseline Kansas City Cardiomyopathy Questionnaire (KCCQ)
Participants
6,263 participants
Comparison
Dapagliflozin vs placebo
Primary endpoint
Changes in the 23 individual KCCQ components (scaled 0–100)
Follow-up
8 months
Methodological detailspost hoc exploratory analysis, double-blind, placebo-controlled, 353 centres in 20 countries
  • Post hoc exploratory analysis
  • Double-blind
  • Placebo-controlled
  • 353 centres in 20 countries

Primary result

As reported in the abstract

Individual KCCQ components
Dapagliflozin vs PlaceboDifference (95% CI)P value
Frequency of lower limb edema
3.2(1.6–4.8)
P < 0.001
Sleep limitation by shortness of breath
3.0(1.6–4.4)
P < 0.001
Limitation in desired activities by shortness of breath
2.8(1.3–4.3)
P < 0.001

Further findings

KCCQ components, longitudinal analysis (months 1, 4 and 8)

Similar treatment patterns

Proportions improving or deteriorating

More patients improved and fewer deteriorated with dapagliflozin across most components

Original publication

Association of Dapagliflozin vs Placebo With Individual Kansas City Cardiomyopathy Questionnaire Components in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Secondary Analysis of the DELIVER Trial. JAMA Cardiol. Published 1 July 2023. doi:10.1001/jamacardio.2023.1342

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