Heart failure & cardiomyopathiesSecondary analysis
Effect of In-Hospital Initiation of Dapagliflozin on Decongestion in Patients Hospitalized for Heart Failure
- Secondary analysis of the DAPA ACT HF-TIMI 68 randomised trial
- prespecified analysis
- placebo-controlled
Authors' conclusion
In-hospital initiation of dapagliflozin led to modest but significant improvements across multiple measures of congestion within 1 week that were sustained through 2 months. Diuretic efficiency progressively improved through 2 months.
Study context
- Population
- Patients hospitalized for HF
- Comparison
- In-hospital initiation of dapagliflozin vs placebo
- Primary endpoint
- Placebo-adjusted changes in modified EVEREST CCS, body weight, mean daily loop diuretic dose and diuretic efficiency
- Follow-up
- 1 week, 1 month and 2 months
Primary result
As reported in the abstract
Decongestion endpoints · 1 week
- Composite Congestion Score (CCS)
- LSMD −0.18 (95% CI −0.33 to −0.04); P = 0.011
- body weight
- LSMD −0.60 kg (95% CI −0.95 to −0.26); P < 0.001
- mean daily loop diuretic dose
- LSMD −0.12 furosemide 40-mg IV equivalents (95% CI −0.22 to −0.02); P = 0.014
- diuretic efficiency
- LSMD −0.93 kg/furosemide 40 mg IV equivalents (95% CI −1.61 to −0.25); P = 0.008
Further findings
| Outcome | LSMD (kg/furosemide 40 mg IV equivalents) (95% CI) | P value |
|---|---|---|
| Diuretic efficiency · 2 months | −1.99 (−3.19 to −0.78) | P < 0.001 |
Diuretic efficiency · 2 months
- Improvements sustained through 2 months
Congestion at randomization (CCS)
- No congestion (CCS 0)
- 12%
- Mild-to-moderate congestion (CCS 1-3)
- 63%
- Severe congestion (CCS 4-9)
- 24%
Original publication
Effect of In-Hospital Initiation of Dapagliflozin on Decongestion in Patients Hospitalized for Heart Failure. JACC Heart Fail. Published 30 August 2026. doi:10.1016/j.jchf.2026.103366
Summarised from the published abstract; every number is checked against it