Heart failure & cardiomyopathiesSecondary analysis
Effects of Dapagliflozin on Symptoms, Function, and Quality of Life in Patients With Heart Failure and Reduced Ejection Fraction
- Secondary analysis of the DAPA-HF randomised trial
Authors' conclusion
Dapagliflozin reduced cardiovascular death and worsening heart failure across the range of baseline KCCQ, and improved symptoms, physical function, and quality of life in patients with heart failure and reduced ejection fraction.
Study context
- Population
- Patients with HFrEF with Kansas City Cardiomyopathy Questionnaire (KCCQ) available at baselineKCCQ at baseline
- Participants
- 4,443 patients
- Comparison
- Dapagliflozin vs placebo
Primary result
As reported in the abstract
CV death or worsening HF, by baseline KCCQ-TSS tertile
Dapagliflozin vs PlaceboHazard ratio (95% CI)
lowest KCCQ-TSS tertile
0.70(0.57–0.86)
middle KCCQ-TSS tertile
0.77(0.61–0.98)
highest KCCQ-TSS tertile
0.62(0.46–0.83)
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Deterioration in KCCQ-TSS · 8 months | 0.84 (0.78–0.90) | P < 0.0001 | |
| At least small, moderate and large KCCQ-TSS improvements · 8 months — Dapagliflozin vs Placebo · small; NNT=14 | 1.15 (1.08–1.23) | P < 0.0001 | |
| At least small, moderate and large KCCQ-TSS improvements · 8 months — Dapagliflozin vs Placebo · moderate; NNT=15 | 1.15 (1.08–1.22) | P < 0.0001 | |
| At least small, moderate and large KCCQ-TSS improvements · 8 months — Dapagliflozin vs Placebo · large; NNT=18 | 1.14 (1.07–1.22) | P < 0.0001 | |
| 0.512Odds ratio (log scale) |
| Outcome | difference (points) | P value |
|---|---|---|
| Mean KCCQ-TSS, clinical summary score, overall summary score · 8 months — Dapagliflozin vs Placebo · KCCQ-TSS | 2.8 | P < 0.0001 |
| Mean KCCQ-TSS, clinical summary score, overall summary score · 8 months — Dapagliflozin vs Placebo · clinical summary score | 2.5 | P < 0.0001 |
| Mean KCCQ-TSS, clinical summary score, overall summary score · 8 months — Dapagliflozin vs Placebo · overall summary score | 2.3 | P < 0.0001 |
- At least small, moderate and large KCCQ-TSS improvements: results consistent for KCCQ clinical summary score and overall summary score
Original publication
Effects of Dapagliflozin on Symptoms, Function, and Quality of Life in Patients With Heart Failure and Reduced Ejection Fraction. Circulation. Published 17 November 2019. doi:10.1161/circulationaha.119.044138
Summarised from the published abstract; every number is checked against it