Heart failure & cardiomyopathiesSecondary analysis
Contemporary Use and Implications of Beta-Blockers in Patients With Heart Failure with Mildly Reduced Ejection Fraction (HFmrEF) or Heart Failure with Preserved Ejection Fraction (HFpEF)
- Secondary analysis of the DELIVER randomised trial
- prespecified analysis
- 20 countries
Authors' conclusion
Beta-blocker use was not associated with a higher risk of worsening HF or cardiovascular death. Dapagliflozin consistently and safely reduced clinical events, irrespective of background beta-blocker use.
Study context
- Population
- Symptomatic heart failure (HF) with left ventricular ejection fraction (LVEF) >40% (HFmrEF or HFpEF) randomised to dapagliflozin or placebo5,177 (83%) on beta-blockers
- Participants
- 6,263 participants
- Comparison
- Beta-blocker use vs no beta-blocker use at randomisation; dapagliflozin vs placebo by beta-blocker use
- Beta-blockersn = 5,177
- Primary endpoint
- CV death or worsening HF
Primary result
As reported in the abstract
Hazard ratio (95% CI)
Beta-blockers vs No beta-blockerscovariate-adjusted
0.70(0.60–0.83)
Dapagliflozin vs Placebopatients taking beta-blockers
0.82(0.72–0.94)
Dapagliflozin vs Placebopatients not taking beta-blockers
0.79(0.61–1.03)
Secondary outcomes
Key secondary endpoints
- Similar findings for dapagliflozin regardless of beta-blocker use
Safety
Adverse events
- Balanced between dapagliflozin and placebo, regardless of background beta-blocker use
Original publication
Contemporary Use and Implications of Beta-Blockers in Patients With HFmrEF or HFpEF. JACC Heart Fail. Published 27 September 2023. doi:10.1016/j.jchf.2023.09.007
Summarised from the published abstract; every number is checked against it