Heart failure & cardiomyopathies

Sodium-Glucose Cotransporter 2 Inhibitor With and Without an Aldosterone Antagonist for Heart Failure With Preserved Ejection Fraction: The SOGALDI-PEF Trial

J Am Coll CardiolPublished Randomised crossover trial

Primary result · LogNT-proBNPResult — go to the resultDifference −0.11 Log-units 95% CI −0.22 to −0.01

Authors' conclusion

Dapagliflozin/spironolactone combination reduced NT-proBNP more than dapagliflozin. A greater eGFR decline and potassium increase was observed with dapagliflozin/spironolactone combination

Study context

Population
HF with mildly reduced or preserved EFrandomised
Participants
108 participants
Comparison
Dapagliflozin/spironolactone vs dapagliflozin alone
Primary endpoint
LogNT-proBNP difference between dapagliflozin/spironolactone combination and dapagliflozin alone sequences
Follow-up
12 weeks per treatment sequence
Methodological detailsprospective, open, blinded endpoint
  • Prospective
  • Open
  • Blinded endpoint

Primary result

LogNT-proBNP

Difference

−0.11 Log-units

95% CI −0.22 to −0.01

P = 0.035

Dapagliflozin/spironolactonevs Dapagliflozin
difference −0.11 Log-units (95% CI −0.22 to −0.01); P = 0.035

As reported in the abstract

Further findings

OutcomeOR (95% CI)P value
≥20% NT-proBNP reduction2.27 (1.16–4.44)P = 0.016
OutcomeDifference (mm Hg) (95% CI)
SBP−5.2 (−8.4 to −2.0)
OutcomeDifference (Log) (95% CI)
Log urinary albumin-to-creatinine ratio−0.32 (−0.54 to −0.11)

Safety

OutcomeDifference (mL/min/1.73 m²) (95% CI)
eGFRDecrease−6.4 (−8.3 to −4.4)

Serum potassium >5.5 mmol/L

OutcomeDifference (mmol/L) (95% CI)
Serum potassium+0.32 (0.23–0.41)

Original publication

Sodium-Glucose Cotransporter 2 Inhibitor With and Without an Aldosterone Antagonist for Heart Failure With Preserved Ejection Fraction: The SOGALDI-PEF Trial. J Am Coll Cardiol. Published 5 August 2025. doi:10.1016/j.jacc.2025.05.033

Composed by AI from the published abstract and checked against it. How Briefs are made →

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