Heart failure & cardiomyopathies
Dapagliflozin in Patients With Heart Failure and Deterioration in Renal Function
Authors' conclusion
Patients with deterioration of eGFR to <25 mL/min/1.73 m2 had elevated risks of cardiovascular outcomes yet appeared to benefit from continuation of dapagliflozin with no excess in safety outcomes between treatment groups.
Study context
- Population
- Patients with heart failure (HF) in DAPA-HF and DELIVER; subgroups with vs without deterioration of estimated glomerular filtration rate (eGFR) to <25 mL/min/1.73 m² in follow-up347 (3.2%) with eGFR <25
- Participants
- 11,007 patients
- Comparison
- Dapagliflozin vs placebo, by deterioration of eGFR to <25 mL/min/1.73 m²
- Outcome
- Primary composite outcome
Methodological detailstime-updated Cox proportional hazard models
- Time-updated Cox proportional hazard models
Pooled result
As reported in the abstract
Primary composite outcome, by eGFR deterioration (subgroups)
Dapagliflozin vs PlaceboHazard ratio (95% CI)
Deterioration of eGFR to <25
0.53(0.33–0.83)
No deterioration of eGFR to <25
0.78(0.72–0.86)
Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Primary composite outcome, deteriorationvs no deterioration of eGFR to <25 | 1.87 (1.48–2.35) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Safety
Safety outcomes, incl. drug discontinuation
- Higher risk with eGFR deterioration to <25; rates similar between treatment groups, incl. those remaining on study drug
Original publication
Dapagliflozin in Patients With Heart Failure and Deterioration in Renal Function. J Am Coll Cardiol. Published 25 August 2023. doi:10.
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