Heart failure & cardiomyopathies
Efficacy of Dapagliflozin According to Heart Rate: A Patient-Level Pooled Analysis of DAPA-HF and DELIVER
Authors' conclusion
The risk of worsening heart failure or cardiovascular death increased with increasing baseline HR among patients in SR, but this association was not seen among patients in AF, irrespective of left ventricular ejection fraction. The benefit of dapagliflozin was consistent across HR range, irrespective of left ventricular ejection fraction or rhythm.
Study context
- Population
- Patients with HF across the range of LVEF (HFrEF in DAPA-HF; HF with mildly reduced EF/HFpEF in DELIVER), in sinus rhythm (SR) or atrial fibrillation (AF)SR n=6401 (64%)
- Comparison
- Dapagliflozin vs placebo, by baseline HR
- Outcome
- Worsening HF or CV death
Pooled result
As reported in the abstract
Primary outcome, dapagliflozin vs placebo by baseline HR (SR)
Dapagliflozin vs PlaceboHazard ratio (95% CI)
SR <60 bpm
0.72(0.55–0.95)
SR 60 to 69 bpm
0.78(0.63–0.97)
SR 70 to 79 bpm
0.73(0.59–0.91)
SR ≥80 bpm
0.77(0.61–0.97)
Further pooled results
Primary outcome rate by baseline HR (SR)
Per 100 person-years
- HR ≥80 bpm
- 16.8
- HR <60 bpm
- 7.7
- HR–risk relationship steeper in HFrEF than HF with mildly reduced EF/HFpEF
- HR not associated with outcomes in AF, either HF phenotype
Original publication
Efficacy of Dapagliflozin According to Heart Rate: A Patient-Level Pooled Analysis of DAPA-HF and DELIVER. Circ Heart Fail. Published 27 October 2023. doi:10.
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