Heart failure & cardiomyopathiesSecondary analysis
Severe Heart Failure and Treatment With Dapagliflozin Across the Ejection Fraction Spectrum
- Pooled secondary analysis of the DAPA-HF and DELIVER randomised trials
- subgroup analysis by severe heart failure (HF) status
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 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
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. 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