Heart failure & cardiomyopathiesMeta-analysis
Dapagliflozin in Patients with Heart Failure and Previous Myocardial Infarction: A Participant-Level Pooled Analysis of DAPA-HF and DELIVER
- Participant-level pooled analysis of the DAPA-HF and DELIVER randomised trials
- subgroup analysis by history of myocardial infarction (MI)
Authors' conclusion
History of MI confers increased risks of adverse cardiovascular outcomes in patients with HF across the LVEF spectrum, even among those with preserved ejection fraction. Dapagliflozin consistently and safely reduces the risk of cardiovascular death or worsening HF, regardless of previous MI.
Study context
- Population
- Symptomatic heart failure (HF) with left ventricular ejection fraction (LVEF) ≤40% (DAPA-HF) or >40% (DELIVER), with or without previous MI3,731 (34%) with previous MI
- Participants
- 11,007 participants
- Comparison
- Dapagliflozin vs placebo, by previous MI
- Outcome
- CV death or worsening HF
Pooled result
As reported in the abstract
CV death or worsening HF, by previous MI
Dapagliflozin vs PlaceboHazard ratio (95% CI)
previous MI
0.83(0.72–0.96)
no previous MI
0.76(0.68–0.85)
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| CV death or worsening HF: previous MI vs no previous MI (covariate-adjusted) | 1.12 (1.02–1.24) | |
| 0.512Hazard ratio (log scale) |
Key secondary outcomes
- Consistent benefits of dapagliflozin irrespective of previous MI
Original publication
Dapagliflozin in Patients with Heart Failure and Previous Myocardial Infarction: A Participant-Level Pooled Analysis of DAPA-HF and DELIVER. Eur J Heart Fail. Published 15 March 2024. doi:10.1002/ejhf.3184
Summarised from the published abstract; every number is checked against it