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  • Butt, Jawad H. (author)

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.

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • 2021
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-512644
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512644URI
  • https://doi.org/10.1161/CIRCHEARTFAILURE.121.008837DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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 and genre

  • MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
  • MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
  • 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

Added entries (persons, corporate bodies, meetings, titles ...)

  • Adamson, Carly (author)
  • Docherty, Kieran F. (author)
  • de Boer, Rudolf A. (author)
  • Petrie, Mark C. (author)
  • Inzucchi, Silvio E. (author)
  • Kosiborod, Mikhail N. (author)
  • Maria Langkilde, Anna (author)
  • Lindholm, Daniel (author)
  • Martinez, Felipe A. (author)
  • Bengtsson, Olof (author)
  • Schou, Morten (author)
  • O’Meara, Eileen (author)
  • Ponikowski, Piotr (author)
  • Sabatine, Marc S. (author)
  • Sjostrand, Mikaela (author)
  • Solomon, Scott D. (author)
  • Jhund, Pardeep S. (author)
  • McMurray, John J. V. (author)
  • Kober, Lars (author)

Related titles

  • In:Circulation. Heart failure14:12

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