Heart failure & cardiomyopathiesSecondary analysis
Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age
- Secondary analysis of the DAPA-HF randomised trial
- subgroup analysis by age
Authors' conclusion
Dapagliflozin reduced the risk of death and worsening heart failure and improved symptoms across the broad spectrum of age studied in DAPA-HF. There was no significant imbalance in tolerability or safety events between dapagliflozin and placebo, even in elderly individuals.
Study context
- Population
- HFrEF patients (NYHA class II or greater, LVEF ≤40%, modest NT-proBNP elevation) in DAPA-HF; excluded SBP <95 mm Hg and eGFR <30aged 22 to 94 years
- Participants
- 4,744 patients
- Comparison
- Dapagliflozin vs placebo, by age
- Primary endpoint
- Composite of:
- Worsening HF (HF hospitalization or urgent HF visit)
- CV death
Primary result
As reported in the abstract
Primary outcome by age group
Dapagliflozin vs PlaceboHazard ratio (95% CI)
<55 years (n=636); placebo rate 13.6 per 100 person-years
0.87(0.60–1.28)
55 to 64 years (n=1242); placebo rate 15.7 per 100 person-years
0.71(0.55–0.93)
65 to 74 years (n=1717); placebo rate 15.1 per 100 person-years
0.76(0.61–0.95)
≥75 years (n=1149); placebo rate 18.0 per 100 person-years
0.68(0.53–0.88)
Further findings
Components of the primary outcome, all-cause mortality, symptoms
- Consistent benefits across age groups
Safety
Adverse events and study drug discontinuation
- Increased with age; neither significantly more common with dapagliflozin in any age group
Original publication
Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age. Circulation. Published 17 November 2019. doi:10.1161/circulationaha.119.044133
Summarised from the published abstract; every number is checked against it