Heart failure & cardiomyopathiesSecondary analysis

In‐hospital course of patients with heart failure with improved ejection fraction in the DELIVER trial

Eur J Heart FailPublished

  • Secondary analysis of the DELIVER randomised trial

Left ventricular ejection fraction (LVEF) changes extracted using a validated GPT-3.5 large language model

Authors' conclusion

Among patients hospitalized for HF in DELIVER, those with HFimpEF experienced a more adverse in-hospital clinical course, necessitating higher resource utilization beyond standard diuretic therapy compared with patients with HF and LVEF consistently >40%, but had similar in-hospital mortality. Treatment benefits of dapagliflozin were not modified by hospitalization type.

Study context

Population
Patients with heart failure (HF) and LVEF >40% randomised to dapagliflozin or placebo in DELIVER, with adjudicated HF hospitalizations
Participants
6,263 patients
Comparison
HFimpEF vs LVEF consistently >40%
  • HFimpEFn = 1,151
Primary endpoint
Complicated HF hospitalization (ICU stay, IV vasopressors/inotropes/vasodilators, invasive or non-invasive ventilation, mechanical fluid removal, ultrafiltration or mechanical circulatory support)
Follow-up
Median 2.3 years

Primary result

As reported in the abstract

Complicated HF hospitalization

P < 0.001

Further findings

LVEF reduction to ≤40% during HF hospitalization (subset with LVEF measurement)

P < 0.001

Length of stay and in-hospital mortality (first HF hospitalization)

No significant difference between HFimpEF and LVEF consistently >40%

Dapagliflozin effect on total uncomplicated and complicated HF hospitalizations, by HFimpEF status

Dapagliflozin reduced total uncomplicated and complicated HF hospitalizations irrespective of HFimpEF status
P for interaction ≥ 0.30
  • interaction P ≥0.30

Original publication

In‐hospital course of patients with heart failure with improved ejection fraction in the DELIVER trial. Eur J Heart Fail. Published 19 September 2024. doi:10.1002/ejhf.3410

Summarised from the published abstract; every number is checked against it