Heart failure & cardiomyopathies
Pulmonary Congestion Relief By Adding Dapagliflozin to Intravenous Loop Diuretic in Acute Heart Failure Patients
Authors' conclusion
Early initiation of SGLT2i administration in addition to intravenous loop diuretics in patients with AHF would optimize congestion relief and improve clinical outcomes.
Study context
- Population
- Patients admitted with an episode of acute heart failure (AHF)patients randomized into two groups
- Participants
- 98 patients
- Comparison
- SGLT2i vs control
- SGLT2in = 49
- controln = 49
Methodological detailsrandomized, intention-to-treat, ANCOVA adjusted for chronic kidney disease status and baseline values
- Randomized
- Intention-to-treat
- ANCOVA adjusted for chronic kidney disease status and baseline values
Main finding
As reported in the abstract
Death · in hospital and 30 days
SGLT2i
1/49
events
Control
2/49
events
Secondary outcomes
24-h urinary Na
| Outcome | SGLT2i | Control |
|---|---|---|
| Body weight change | adjusted mean change −4.90 (SE 0.93) kg | adjusted mean change −4.28 (SE 0.81) kg |
| B-lines · discharge and 1 month | ||
| Discharge | −19.93 ± 0.87 | −18.64 ± 0.79 |
| 1 month | −19.65 ± 1.54 | −14.82 ± 1.43 |
| One-month echocardiographic changes | ||
| Left ventricular ejection fraction | 5% (0.35% to 11.5%) | 0 (−1% to +5%) |
| End-diastolic volume | −6.5 mL (−27.5 to +3) | 4 mL (−11.5 to +10) |
- B-lines: discharge P = 0.227
- B-lines: 1 month P = 0.012
- 24-h urinary Na: P = 0.009
One-month echocardiographic changes
- Significantly improved in the SGLT2i group
Safety
| Outcome | SGLT2i | Control |
|---|---|---|
| Worsening renal function | 15/49 events | 6/47 events |
- Worsening renal function: P = 0.048
Original publication
Pulmonary Congestion Relief By Adding Dapagliflozin to Intravenous Loop Diuretic in Acute Heart Failure Patients. ESC Heart Fail. Published 26 June 2025. doi:10.
Summarised from the published abstract; every number is checked against it