Heart failure & cardiomyopathiesSecondary analysis
Cardio-Renal-Metabolic Overlap, Outcomes, and Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction
- Secondary analysis of the DELIVER randomised trial
- post hoc analysis
Authors' conclusion
CRM multimorbidity was common and associated with adverse outcomes among patients with HF and left ventricular ejection fraction >40% in DELIVER. Dapagliflozin was safe and effective across the CRM spectrum, with greater absolute benefits among those with highest CRM overlap
Study context
- Population
- Patients with heart failure (HF) and LVEF >40% in DELIVER
- Participants
- 6,263 patients
- Comparison
- 3 cardio-renal-metabolic (CRM) conditions vs HF alone
- 1 CRM conditionn = 1,952
- 2 CRM conditionsn = 2,245
- 3 CRM conditionsn = 1,236
- Primary endpoint
- CV death or worsening HF
Primary result
As reported in the abstract
Primary outcome (CV death or worsening HF) by CRM overlap
Adjusted hazard ratio
2.16
95% CI 1.72–2.72
P < 0.001
Events by treatment group
3 CRM conditions vs HF alone
adjusted HR 2.16 (95% CI 1.72–2.72); P < 0.001
- Relative benefit of dapagliflozin consistent by type of CRM overlap
- P for interaction = 0.773
- Relative benefit of dapagliflozin consistent by number of CRM conditions
- P for interaction = 0.734
Further findings
Baseline characteristics by CRM multimorbidity
- Greater CRM multimorbidity associated with older age, higher BMI, longer HF duration, worse health status and lower LVEF
Safety
Adverse events
- Adverse events similar between treatment arms across the CRM spectrum
Original publication
Cardio-Renal-Metabolic Overlap, Outcomes, and Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction. JACC Heart Fail. Published 24 May 2023. doi:10.1016/j.jchf.2023.05.015
Summarised from the published abstract; every number is checked against it