Heart failure & cardiomyopathiesRandomised controlled trial
Dapagliflozin in Patients Hospitalized for Heart Failure: Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart Failure
- Randomised controlled trial
- double-blind
- placebo-controlled
- prespecified meta-analysis
- Randomized between September 2020 and March 2025
Authors' conclusion
In this trial, in-hospital initiation of dapagliflozin did not significantly reduce the risk of cardiovascular death or worsening HF through 2 months in hospitalized HF patients.
Study context
- Population
- Patients hospitalized for heart failure (HF)
- Participants
- 2,401 patients
- Comparison
- In-hospital initiation of dapagliflozin vs placebo
- Dapagliflozinn = 1,218
- Placebon = 1,183reference
- Primary endpoint
- Time to CV death or worsening HF
- Follow-up
- 2 months
Primary result
CV death or worsening HF
Hazard ratio
0.86
95% CI 0.68–1.08
P = 0.20
Events by treatment group
Dapagliflozin vs Placebo
HR 0.86 (95% CI 0.68–1.08); P = 0.20
As reported in the abstract
Further findings
| Outcome | Dapagliflozin | Placebo | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Worsening HF event | 9.4% | 10.3% | 0.91 (0.71–1.18) | ||
| CV death | 2.5% | 3.1% | 0.78 (0.48–1.27) | ||
| All-cause death | 3.0% | 4.5% | 0.66 (0.43–1.00) | ||
| Meta-analysis (patients hospitalized for HF): early CV death or worsening HF · prespecified meta-analysis of randomised trials | 0.71 (0.54–0.93) | P = 0.012 | |||
| Meta-analysis (patients hospitalized for HF): all-cause death · prespecified meta-analysis of randomised trials | 0.57 (0.41–0.80) | P = 0.001 | |||
| 0.512Hazard ratio (log scale) |
Safety
Symptomatic hypotension
Worsening kidney function
Original publication
Dapagliflozin in Patients Hospitalized for Heart Failure: Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart Failure. Circulation. Published 29 August 2025. doi:10.1161/circulationaha.125.076575
Summarised from the published abstract; every number is checked against it