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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.
- Article/chapterEnglish2021
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Numbers
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LIBRIS-ID:oai:DiVA.org:uu-512644
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512644URI
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https://doi.org/10.1161/CIRCHEARTFAILURE.121.008837DOI
Supplementary language notes
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Language:English
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Summary in:English
Part of subdatabase
Classification
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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 and genre
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MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
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MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
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Aged
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Atrial Fibrillation/drug therapy/physiopathology
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Benzhydryl Compounds/*adverse effects/*therapeutic use
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clinical trials
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Clinical Trials as Topic
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Glucosides/*adverse effects/*therapeutic use
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heart failure with reduced ejection fraction
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Heart Failure/*drug therapy/physiopathology
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Hospitalization/statistics & numerical data
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Humans
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Male
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Middle Aged
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Natriuretic Peptide
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Brain/*therapeutic use
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natriuretic peptides
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Peptide Fragments/*therapeutic use
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sodium-glucose cotransporter 2 inhibitors
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Stroke Volume/drug effects
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Ventricular Function
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Left/drug effects
Added entries (persons, corporate bodies, meetings, titles ...)
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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)
Related titles
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In:Circulation. Heart failure14:12
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Butt, Jawad H.
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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Uppsala University