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Efficacy and Safety...
Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to N-Terminal Pro-B-Type Natriuretic Peptide : Insights From the DAPA-HF Trial.
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Butt, Jawad H. (author)
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Adamson, Carly (author)
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Docherty, Kieran F. (author)
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de Boer, Rudolf A. (author)
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Petrie, Mark C. (author)
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Inzucchi, Silvio E. (author)
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Kosiborod, Mikhail N. (author)
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Maria Langkilde, Anna (author)
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Lindholm, Daniel (author)
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Martinez, Felipe A. (author)
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Bengtsson, Olof (author)
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Schou, Morten (author)
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O’Meara, Eileen (author)
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Ponikowski, Piotr (author)
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Sabatine, Marc S. (author)
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Sjostrand, Mikaela (author)
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Solomon, Scott D. (author)
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Jhund, Pardeep S. (author)
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McMurray, John J. V. (author)
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Kober, Lars (author)
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- 2021
- 2021
- English.
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In: Circulation. Heart failure. ; 14:12
- 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
Subject headings
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- BACKGROUND: Effective therapies for HFrEF usually reduce NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels, and it is important to establish whether new treatments are effective across the range of NT- proBNP. METHODS: We evaluated both these questions in the DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure) trial. Patients in New York Heart Association functional class II to IV with a left ventricular ejection fraction $<$/=40% and a NT-proBNP level $>$/=600 pg/mL ($>$/=600 ng/L; $>$/=400 pg/mL if hospitalized for HF within the previous 12 months or $>$/=900 pg/mL if atrial fibrillation/flutter) were eligible. The primary outcome was the composite of an episode of worsening HF or cardiovascular death. RESULTS: Of the 4744 randomized patients, 4742 had an available baseline NT-proBNP measurement (median, 1437 pg/mL [interquartile range, 857-2650 pg/mL]). Compared with placebo, treatment with dapagliflozin significantly reduced NT-proBNP from baseline to 8 months (absolute least-squares mean reduction, -303 pg/mL [95% CI, -457 to -150 pg/mL]; geometric mean ratio, 0.92 [95% CI, 0.88-0.96]). Dapagliflozin reduced the risk of worsening HF or cardiovascular death, irrespective of baseline NT-proBNP quartile; the hazard ratio for dapagliflozin versus placebo, from lowest to highest quartile was 0.43 (95% CI, 0.27-0.67), 0.77 (0.56-1.04), 0.78 (0.60-1.01), and 0.78 (0.64-0.95); P for interaction=0.09. Consistent benefits were observed for all-cause mortality. Compared with placebo, dapagliflozin increased the proportion of patients with a meaningful improvement ($>$/=5 points) in Kansas City Cardiomyopathy Questionnaire total symptom score (P for interaction=0.99) and decreased the proportion with a deterioration $>$/=5 points (P for interaction=0.87) across baseline NT-proBNP quartiles. CONCLUSIONS: In patients with HFrEF, dapagliflozin reduced NT-proBNP by 300 pg/mL after 8 months of treatment compared with placebo. In addition, dapagliflozin reduced the risk of worsening HF and death, and improved symptoms, across the spectrum of baseline NT-proBNP levels included in DAPA-HF. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03036124.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Aged
- Atrial Fibrillation/drug therapy/physiopathology
- Benzhydryl Compounds/*adverse effects/*therapeutic use
- clinical trials
- Clinical Trials as Topic
- Glucosides/*adverse effects/*therapeutic use
- heart failure with reduced ejection fraction
- Heart Failure/*drug therapy/physiopathology
- Hospitalization/statistics & numerical data
- Humans
- Male
- Middle Aged
- Natriuretic Peptide
- Brain/*therapeutic use
- natriuretic peptides
- Peptide Fragments/*therapeutic use
- sodium-glucose cotransporter 2 inhibitors
- Stroke Volume/drug effects
- Ventricular Function
- Left/drug effects
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Butt, Jawad H.
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Adamson, Carly
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Docherty, Kieran ...
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de Boer, Rudolf ...
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Petrie, Mark C.
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Inzucchi, Silvio ...
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show more...
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Kosiborod, Mikha ...
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Maria Langkilde, ...
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Lindholm, Daniel
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Martinez, Felipe ...
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Bengtsson, Olof
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Schou, Morten
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O’Meara, Eileen
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Ponikowski, Piot ...
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Sabatine, Marc S ...
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Sjostrand, Mikae ...
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Solomon, Scott D ...
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Jhund, Pardeep S ...
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McMurray, John J ...
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Kober, Lars
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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
- Circulation. Hea ...
- By the university
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Uppsala University