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Dapagliflozin and D...
Dapagliflozin and Diuretic Use in Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF.
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Jackson, Alice M. (author)
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Dewan, Pooja (author)
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Anand, Inder S. (author)
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Belohlavek, Jan (author)
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Bengtsson, Olof (author)
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de Boer, Rudolf A. (author)
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Bohm, Michael (author)
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Boulton, David W. (author)
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Chopra, Vijay K. (author)
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DeMets, David L. (author)
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Docherty, Kieran F. (author)
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Dukat, Andrej (author)
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Greasley, Peter J. (author)
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Howlett, Jonathan G. (author)
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Inzucchi, Silvio E. (author)
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Katova, Tzvetana (author)
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Kober, Lars (author)
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Kosiborod, Mikhail N. (author)
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Langkilde, Anna Maria (author)
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Lindholm, Daniel (author)
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- Ljungman, Charlotta, 1977 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Martinez, Felipe A. (author)
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O’Meara, Eileen (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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Tereshchenko, Sergey (author)
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Verma, Subodh (author)
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Jhund, Pardeep S. (author)
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McMurray, John J. V. (author)
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Anand, Inder D (author)
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Bengtfors, Olof (author)
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(creator_code:org_t)
- 2020
- 2020
- English.
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In: Circulation. - 1524-4539. ; 142:11, s. 1040-1054
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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Abstract
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- BACKGROUND: In the DAPA-HF trial (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure), the sodium-glucose cotransporter 2 inhibitor dapagliflozin reduced the risk of worsening heart failure and death in patients with heart failure and reduced ejection fraction. We examined the efficacy and tolerability of dapagliflozin in relation to background diuretic treatment and change in diuretic therapy after randomization to dapagliflozin or placebo. METHODS: We examined the effects of study treatment in the following subgroups: no diuretic and diuretic dose equivalent to furosemide $<$40, 40, and $>$40 mg daily at baseline. We examined the primary composite end point of cardiovascular death or a worsening heart failure event and its components, all-cause death and symptoms. RESULTS: Of 4616 analyzable patients, 736 (15.9%) were on no diuretic, 1311 (28.4%) were on $<$40 mg, 1365 (29.6%) were on 40 mg, and 1204 (26.1%) were taking $>$40 mg. Compared with placebo, dapagliflozin reduced the risk of the primary end point across each of these subgroups: hazard ratios were 0.57 (95% CI, 0.36-0.92), 0.83 (95% CI, 0.63-1.10), 0.77 (95% CI, 0.60-0.99), and 0.78 (95% CI, 0.63-0.97), respectively (P for interaction=0.61). The hazard ratio in patients taking any diuretic was 0.78 (95% CI, 0.68-0.90). Improvements in symptoms and treatment toleration were consistent across the diuretic subgroups. Diuretic dose did not change in most patients during follow- up, and mean diuretic dose did not differ between the dapagliflozin and placebo groups after randomization. CONCLUSIONS: The efficacy and safety of dapagliflozin were consistent across the diuretic subgroups examined 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
- Aged
- 80 and over
- Benzhydryl Compounds/*administration & dosage
- diuretics
- Diuretics/*administration & dosage
- Female
- Glucosides/*administration & dosage
- heart failure
- Heart Failure/*drug therapy/*physiopathology
- Humans
- Male
- Middle Aged
- sodium-glucose transporter 2 inhibitors
- Stroke Volume/*drug effects
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Jackson, Alice M ...
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Dewan, Pooja
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Anand, Inder S.
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Belohlavek, Jan
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Bengtsson, Olof
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de Boer, Rudolf ...
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show more...
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Bohm, Michael
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Boulton, David W ...
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Chopra, Vijay K.
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DeMets, David L.
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Docherty, Kieran ...
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Dukat, Andrej
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Greasley, Peter ...
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Howlett, Jonatha ...
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Inzucchi, Silvio ...
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Katova, Tzvetana
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Kober, Lars
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Kosiborod, Mikha ...
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Langkilde, Anna ...
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Lindholm, Daniel
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Ljungman, Charlo ...
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Martinez, Felipe ...
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O’Meara, Eileen
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Sabatine, Marc S ...
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Sjostrand, Mikae ...
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Solomon, Scott D ...
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Tereshchenko, Se ...
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Verma, Subodh
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Jhund, Pardeep S ...
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McMurray, John J ...
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Anand, Inder D
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Bengtfors, Olof
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show less...
- 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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Circulation
- By the university
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Uppsala University
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University of Gothenburg