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Dapagliflozin for H...
Dapagliflozin for Heart Failure According to Body Mass Index : The DELIVER Trial.
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Adamson, Carly (author)
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Kondo, Toru (author)
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Jhund, Pardeep S. (author)
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de Boer, Rudolf A. (author)
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Cabrera Honorio, Jose Walter (author)
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Claggett, Brian (author)
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Desai, Akshay S. (author)
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Alcocer Gamba, Marco Antonio (author)
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Al Habeeb, Waleed (author)
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Hernandez, Adrian F. (author)
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Inzucchi, Silvio E. (author)
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Kosiborod, Mikhail N. (author)
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Lam, Carolyn S. P. (author)
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Langkilde, Anna Maria (author)
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Lindholm, Daniel (author)
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Bachus, Erasmus (author)
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Litwin, Sheldon E. (author)
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Martinez, Felipe (author)
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Petersson, Magnus (author)
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Shah, Sanjiv J. (author)
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Vaduganathan, Muthiah (author)
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Nguyen Vinh, Pham (author)
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Wilderang, Ulrica (author)
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Solomon, Scott D. (author)
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McMurray, John J. V. (author)
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- 2022-08-27
- 2022
- English.
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In: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 43:41, s. 4406-4417
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- AIMS: Obesity is common and associated with unique phenotypic features in heart failure with preserved ejection fraction (HFpEF). Therefore, understanding the efficacy and safety of new therapies in HFpEF patients with obesity is important. The effects of dapagliflozin were examined according to body mass index (BMI) among patients in the Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure trial. METHODS AND RESULTS: Body mass index was analysed by World Health Organization (WHO) categories and as a continuous variable using restricted cubic splines. Body mass index ranged from 15.2 to 50 kg/m2 with a mean value of 29.8 (standard deviation +/- 6.1) kg/m2. The proportions, by WHO category, were: normal weight 1343 (21.5%); overweight 2073 (33.1%); Class I obesity 1574 (25.2%); Class II obesity 798 (12.8%); and Class III obesity 415 (6.6%). Compared with placebo, dapagliflozin reduced the risk of the primary outcome to a similar extent across these categories: hazard ratio (95% confidence interval): 0.89 (0.69-1.15), 0.87 (0.70-1.08), 0.74 (0.58-0.93), 0.78 (0.57-1.08), and 0.72 (0.47-1.08), respectively (P-interaction = 0.82). The placebo-corrected change in Kansas City Cardiomyopathy Questionnaire total symptom score with dapagliflozin at 8 months was: 0.9 (-1.1, 2.8), 2.5 (0.8, 4.1), 1.9 (-0.1, 3.8), 2.7 (-0.5, 5.8), and 8.6 (4.0, 13.2) points, respectively (P-interaction = 0.03). The placebo-corrected change in weight at 12 months was: -0.88 (-1.28, -0.47), -0.65 (-1.04, -0.26), -1.42 (-1.89, -0.94), -1.17 (-1.94, -0.40), and -2.50 (-4.4, -0.64) kg (P-interaction = 0.002). CONCLUSIONS: Obesity is common in patients with HFpEF and is associated with higher rates of heart failure hospitalization and worse health status. Treatment with dapagliflozin improves cardiovascular outcomes across the spectrum of BMI, leads to greater symptom improvement in patients with obesity, compared with those without, and has the additional benefit of causing modest weight loss.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- *Heart Failure/drug therapy/complications
- Body mass index
- Body Mass Index
- Heart failure
- Humans
- Obesity
- Obesity/complications
- SGLT2 inhibitor
- Stroke Volume
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Adamson, Carly
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Kondo, Toru
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Jhund, Pardeep S ...
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de Boer, Rudolf ...
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Cabrera Honorio, ...
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Claggett, Brian
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show more...
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Desai, Akshay S.
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Alcocer Gamba, M ...
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Al Habeeb, Walee ...
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Hernandez, Adria ...
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Inzucchi, Silvio ...
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Kosiborod, Mikha ...
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Lam, Carolyn S. ...
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Langkilde, Anna ...
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Lindholm, Daniel
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Bachus, Erasmus
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Litwin, Sheldon ...
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Martinez, Felipe
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Petersson, Magnu ...
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Shah, Sanjiv J.
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Vaduganathan, Mu ...
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Nguyen Vinh, Pha ...
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Wilderang, Ulric ...
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Solomon, Scott D ...
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McMurray, John J ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European heart j ...
- By the university
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Uppsala University