Heart failure & cardiomyopathies
Effect of Dapagliflozin in Patients with Diabetes and Heart Failure with Mildly Reduced or Preserved Ejection Fraction According to Background Glucose-Lowering Therapy: A Pre-Specified Analysis of the DELIVER Trial
Authors' conclusion
Dapagliflozin safely and consistently improved clinical outcomes among individuals with T2D and HF with LVEF >40% irrespective of the number and class of background GLTs, and the benefits were not influenced by concomitant metformin or insulin use.
Study context
- Population
- Patients with T2DM and heart failure (HF) with left ventricular ejection fraction (LVEF) >40%participants with T2D
- Participants
- 3,150 patients
- Comparison
- Dapagliflozin vs placebo, by background glucose-lowering therapy
- Primary endpoint
- Composite of:
- Worsening HF (HF hospitalization or urgent HF visit)
- CV death
- Follow-up
- Median 2.3 years
Methodological detailspre-specified subgroup analysis, placebo-controlled
- Pre-specified subgroup analysis
- Placebo-controlled
Primary result
As reported in the abstract
Primary outcome by number of background glucose-lowering therapy (GLTs) · median 2.3 years
Dapagliflozin vs PlaceboHazard ratio (95% CI)
0 GLTs (22.9%)
0.71(0.50–1.00)
1 GLT (36.5%)
1.04(0.80–1.34)
≥2 GLTs (40.6%)
0.71(0.56–0.90)
Further findings
Primary outcome, by background metformin use (subgroup) · median 2.3 years
- With metformin: HR, dapagliflozin vs placebo
- 0.73 (0.59-0.92) (95% CI)
- Without metformin: HR, dapagliflozin vs placebo
- 0.89 (0.72-1.11) (95% CI)
- Pinteraction = 0.22
Primary outcome, by background insulin use (subgroup) · median 2.3 years
- With insulin: HR, dapagliflozin vs placebo
- 0.89 (0.69-1.16) (95% CI)
- Without insulin: HR, dapagliflozin vs placebo
- 0.78 (0.65-0.95) (95% CI)
- Pinteraction = 0.45
Original publication
Effect of Dapagliflozin in Patients with Diabetes and Heart Failure with Mildly Reduced or Preserved Ejection Fraction According to Background Glucose-Lowering Therapy: A Pre-Specified Analysis of the DELIVER Trial. Eur J Heart Fail. Published 15 May 2024. doi:10.
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