Heart failure & cardiomyopathiesSecondary analysis
Cellular Adhesion Molecules and Adverse Outcomes in Chronic Heart Failure
- Secondary analysis of the DAPA-HF randomised trial
- biomarker substudy
- multicentre
- Mean (SD) follow-up 17.6 (5.2) months
Authors' conclusion
Results of this substudy of the DAPA-HF randomized clinical trial demonstrate that higher VCAM-1 levels, possibly reflecting a distinct inflammatory/immune pathophysiological pathway in HFrEF, were associated with worse outcomes, even after adjustment for conventional prognostic variables.
Study context
- Population
- Patients with HF and reduced ejection fraction (HFrEF), New York Heart Association (NYHA) class II–IV, elevated natriuretic peptides, in the DAPA-HF trial (410 sites, 20 countries)biomarker substudy
- Participants
- 3,051 patients
- Comparison
- VCAM-1 tertile 3 vs tertile 1
- Primary endpoint
- Composite of:
- Worsening heart failure (HF) event
- CV death
Primary result
Primary outcome by baseline VCAM-1 tertile
Adjusted hazard ratio
1.40
95% CI 1.11–1.77
P = 0.004
T3 vs T1
adjusted HR 1.40 (95% CI 1.11–1.77); P = 0.004
As reported in the abstract
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Dapagliflozin vs placebo on primary outcome, by VCAM-1 tertile (subgroup) — Dapagliflozin vs Placebo · tertile 1 | 0.76 (0.54–1.06) | |
| Dapagliflozin vs placebo on primary outcome, by VCAM-1 tertile (subgroup) — Dapagliflozin vs Placebo · tertile 2 | 0.82 (0.59–1.12) | |
| Dapagliflozin vs placebo on primary outcome, by VCAM-1 tertile (subgroup) — Dapagliflozin vs Placebo · tertile 3 | 0.77 (0.61–0.98) | |
| 0.512Hazard ratio (log scale) |
- Dapagliflozin vs placebo on primary outcome, by VCAM-1 tertile (subgroup): P for interaction = .93
Change in VCAM-1 level with dapagliflozin · 52 weeks
- No significant change in VCAM-1 level with dapagliflozin
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Cellular Adhesion Molecules and Adverse Outcomes in Chronic Heart Failure. JAMA Cardiol. Published 1 August 2025. doi:10.1001/jamacardio.2025.1592
Summarised from the published abstract; every number is checked against it