Heart failure & cardiomyopathiesSecondary analysis
Effects of Dapagliflozin According to QRS Duration Across the Spectrum of Left Ventricular Ejection Fraction: An Analysis of DAPA-HF and DELIVER
- Secondary analysis of the DAPA-HF and DELIVER randomised trials
- pooled analysis
- subgroup analysis by QRS duration
Authors' conclusion
Prolongation of QRS duration is associated with worse outcomes irrespective of HF phenotype. Dapagliflozin reduced the risk of the primary outcome, regardless of QRS duration, in DAPA-HF and DELIVER.
Study context
- Population
- Heart failure (HF) patients across the left ventricular ejection fraction (LVEF) spectrum (HFrEF and HFmrEF/HFpEF), excluding paced rhythm and CRT4,008 HFrEF, 5816 HFmrEF/HFpEF
- Comparison
- Dapagliflozin vs placebo, by QRS duration
- Primary endpoint
- CV death or worsening HF
- Follow-up
- Median 23 months
Primary result
As reported in the abstract
CV death or worsening HF, dapagliflozin vs placebo by QRS duration
Dapagliflozin vs PlaceboHazard ratio (95% CI)
QRS <120 ms
0.75(0.67–0.85)
QRS 120-149 ms
0.79(0.65–0.96)
QRS ≥150 ms
0.89(0.70–1.13)
Further findings
CV death or worsening HF event rate by QRS duration (pooled) · median follow-up 23 months
CV death or worsening HF event rate by QRS duration (pooled) · median follow-up 23 months
- Gradient in event rates observed both in HFrEF and HFmrEF/HFpEF
Original publication
Effects of Dapagliflozin According to QRS Duration Across the Spectrum of Left Ventricular Ejection Fraction: An Analysis of DAPA-HF and DELIVER. Eur J Heart Fail. Published 17 July 2024. doi:10.1002/ejhf.3350
Summarised from the published abstract; every number is checked against it