Heart failure & cardiomyopathiesSecondary analysis
Interleukin-6 in Heart Failure With Reduced Ejection Fraction and the Effect of Dapagliflozin
- Secondary analysis of the DAPA-HF randomised trial
Authors' conclusion
In DAPA-HF, elevated IL-6 and hs-CRP levels were each associated with the risk of worsening HF or cardiovascular death. Dapagliflozin reduced the risk of adverse outcomes regardless of baseline IL-6 or hs-CRP.
Study context
- Population
- Patients with HFrEF (NYHA II–IV, LVEF ≤40%, elevated NT-proBNP, eGFR ≥30 mL/min/1.73 m²) in DAPA-HF
- Participants
- 2,940 patients
- Comparison
- IL-6 tertiles; dapagliflozin effect by IL-6 and hs-CRP
- Primary endpoint
- Worsening heart failure (HF) event or CV death
Primary result
As reported in the abstract
Worsening HF event or CV death by baseline IL-6 tertile (adjusted)
Each group vs T1Hazard ratio (95% CI)
T2
1.34(1.04–1.73)
T3
1.80(1.41–2.31)
Further findings
Baseline IL-6 and hs-CRP
- Median IL-6 (Q1-Q3: 4.18-9.28 pg/mL)
- 6.01 pg/mL
- Median hs-CRP (Q1-Q3: 0.83-4.9 mg/L)
- 2.05 mg/L
Change in IL-6 from baseline to 12 months
- Rise in IL-6 associated with worse outcomes
Dapagliflozin effect on primary outcome by IL-6 (and hs-CRP)
- Benefit of dapagliflozin consistent regardless of IL-6; similar for hs-CRP
- continuous interaction P = 0.57
IL-6 and hs-CRP with dapagliflozin · 12 months
- Dapagliflozin did not reduce IL-6 or hs-CRP
Original publication
Interleukin-6 in Heart Failure With Reduced Ejection Fraction and the Effect of Dapagliflozin. JACC Heart Fail. Published 12 March 2025. doi:10.1016/j.jchf.2024.12.012
Summarised from the published abstract; every number is checked against it