Heart failure & cardiomyopathies
Decline in Estimated Glomerular Filtration Rate After Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Secondary Analysis of the DELIVER Randomized Clinical Trial
An erratum to this article was published (JAMA Cardiol, 1 Jul 2024 ↗)
Primary result · Initial eGFR decline >10%Result — go to the resultOdds ratio 1.9 95% CI 1.7–2.1Authors' conclusion
Among patients with HFmrEF or HFpEF treated with dapagliflozin, an initial eGFR decline was frequent but not associated with subsequent risk of cardiovascular or kidney events.
Study context
- Population
- Patients with heart failure with mildly reduced ejection fraction (HFmrEF) or HFpEF (EF >40%, estimated glomerular filtration rate (eGFR) ≥25)
- Participants
- 5,788 patients
- Comparison
- Dapagliflozin vs placebo
- Dapagliflozinn = 2,892
- Placebon = 2,896reference
- Primary endpoint
- Frequency of initial eGFR decline (baseline to month 1), and its association with CV (CV death or HF event) and kidney outcomes
- Follow-up
- Baseline to month 1
Methodological detailsprespecified analysis, international multicentre, DELIVER Aug 2018–Mar 2022; analysed Feb–Oct 2023
- Prespecified analysis
- International multicentre
- DELIVER Aug 2018–Mar 2022; analysed Feb–Oct 2023
Primary result
Initial eGFR decline >10%
Odds ratio
1.9
95% CI 1.7–2.1
P < 0.001 for difference
Events by treatment group
Dapagliflozinvs Placebo
OR 1.9 (95% CI 1.7–2.1); P for difference < 0.001
As reported in the abstract
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Primary CV outcome, initial eGFR decline >10% vs ≤10%, by treatmenteGFR decline >10%vs eGFR decline ≤10%Placebo | 1.33 (1.10–1.62) | |
| Primary CV outcome, initial eGFR decline >10% vs ≤10%, by treatmenteGFR decline >10%vs eGFR decline ≤10%Dapagliflozin | 0.90 (0.74–1.09) | |
| Kidney composite outcome, initial eGFR decline >10%, dapagliflozin-treatedeGFR decline >10%vs eGFR decline ≤10%Dapagliflozin | 0.94 (0.49–1.82) | |
| 0.512Adjusted hazard ratio (log scale) |
Median
| Outcome | Dapagliflozin | Placebo | Difference | P value |
|---|---|---|---|---|
| Change in eGFR, baseline to month 1 | −4 (IQR −9–1) | −1 (IQR −6–5) | −3 | P < 0.001 |
- Primary CV outcome, initial eGFR decline >10% vs ≤10%, by treatment: P for interaction = .01
- Primary CV outcome, initial eGFR decline >10% vs ≤10%, by treatment: landmarked at month 1
Primary CV outcome, initial eGFR decline >10% vs ≤10%, by treatment
- Similar associations with alternative thresholds and as a continuous measure
Original publication
Decline in Estimated Glomerular Filtration Rate After Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Secondary Analysis of the DELIVER Randomized Clinical Trial. JAMA Cardiol. Published 1 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →