Heart failure & cardiomyopathies

Severe Heart Failure and Treatment With Dapagliflozin Across the Ejection Fraction Spectrum: DAPA-HF and DELIVER

JACC Heart FailPublished Pooled secondary analysis of the DAPA-HF and DELIVER randomised trials

Primary result · Prevalence of severe HF and CV death or worsening HF by severe HF statusResult — go to the resultAdjusted hazard ratio 1.85 95% CI 1.60–2.12

Authors' conclusion

Severe HF was associated with an excess risk of CV events across the spectrum of LVEF. Treatment with the SGLT2i dapagliflozin appeared to be safe and effective in reducing the risk of CV death or worsening HF in this population.

Study context

Population
Patients with heart failure (HF) across the left ventricular ejection fraction (LVEF) spectrum in DAPA-HF and DELIVERwith data to define severe HF
Participants
10,948 patients
Comparison
Severe HF vs No severe HF
  • Severe HFn = 730
Primary endpoint
Cardiovascular (CV) death or first worsening HF event
Follow-up
Median 22 months
Methodological detailssubgroup analysis by severe HF status
  • Subgroup analysis by severe HF status

Primary result

As reported in the abstract

Prevalence of severe HF and CV death or worsening HF by severe HF status

Adjusted hazard ratio

1.85

95% CI 1.60–2.12

Events by treatment group

Severe HF

6.7%

730 of 730

Severe HF vs No severe HF
adjusted HR 1.85 (95% CI 1.60–2.12)
Dapagliflozin consistently beneficial for primary endpoint regardless of severe HF status
P for interaction = 0.48
Consistent across the LVEF spectrum
3-way Pinteraction = 0.52

Safety

Safety profile of dapagliflozin

Safety profile consistent regardless of severe HF status

Original publication

Severe Heart Failure and Treatment With Dapagliflozin Across the Ejection Fraction Spectrum: DAPA-HF and DELIVER. JACC Heart Fail. Published 5 March 2025. doi:10.1016/j.jchf.2024.11.023

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

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