Heart failure & cardiomyopathies
Influence of Background Medical Therapy on Efficacy and Safety of Dapagliflozin in Patients with Heart Failure with Improved Ejection Fraction in the DELIVER Trial
Authors' conclusion
In patients with HFimpEF, the safety and efficacy of dapagliflozin were largely similar by background use and dosing of HF medical therapies. The benefit of dapagliflozin in reducing HF events tended to be greater in those patients on 0-1 medications at baseline. Among patients already on three HF medical therapies, the addition of dapagliflozin was safe without requiring de-escalation of other therapies.
Study context
- Population
- Patients with symptomatic heart failure (HF) with improved EF (HFimpEF; prior LVEF ≤40% improved to >40% by enrolment) in DELIVERHFimpEF of 6263 randomized
- Participants
- 1,151 patients
- Comparison
- Dapagliflozin vs placebo, by number of background HF medical therapies
- Primary endpoint
- Worsening HF or CV death
- Follow-up
- Median 2.3 years
Primary result
As reported in the abstract
Primary outcome by number of background HF therapies · median 2.3 years
Proportion of patients 0-1 therapies 21% · 2 therapies 44% · 3 therapies 35%
- Dapagliflozin effect on primary outcome may be greater on 0-1 therapies
- P for interaction = 0.09
- Interaction for HF hospitalization (significant)
- P for interaction = 0.023
- No effect modification for CV death
- P for interaction = 0.65
- Consistent effect across modified Heart Failure Collaboratory Medical Therapy Score
- P for interaction = 0.39
Further findings
- Dapagliflozin not associated with changes in use or doses of background HF therapies
Safety
Adverse events in patients on 3 HF medications
- Addition of dapagliflozin did not lead to higher adverse events
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →