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  • Solomon, Scott D. (author)

Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2022
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-512691
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512691URI
  • https://doi.org/10.1056/NEJMoa2206286DOI

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  • Language:English
  • Summary in:English

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

Notes

  • BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure and cardiovascular death among patients with chronic heart failure and a left ventricular ejection fraction of 40% or less. Whether SGLT2 inhibitors are effective in patients with a higher left ventricular ejection fraction remains less certain. METHODS: We randomly assigned 6263 patients with heart failure and a left ventricular ejection fraction of more than 40% to receive dapagliflozin (at a dose of 10 mg once daily) or matching placebo, in addition to usual therapy. The primary outcome was a composite of worsening heart failure (which was defined as either an unplanned hospitalization for heart failure or an urgent visit for heart failure) or cardiovascular death, as assessed in a time-to-event analysis. RESULTS: Over a median of 2.3 years, the primary outcome occurred in 512 of 3131 patients (16.4%) in the dapagliflozin group and in 610 of 3132 patients (19.5%) in the placebo group (hazard ratio, 0.82; 95% confidence interval [CI], 0.73 to 0.92; P$<$0.001). Worsening heart failure occurred in 368 patients (11.8%) in the dapagliflozin group and in 455 patients (14.5%) in the placebo group (hazard ratio, 0.79; 95% CI, 0.69 to 0.91); cardiovascular death occurred in 231 patients (7.4%) and 261 patients (8.3%), respectively (hazard ratio, 0.88; 95% CI, 0.74 to 1.05). Total events and symptom burden were lower in the dapagliflozin group than in the placebo group. Results were similar among patients with a left ventricular ejection fraction of 60% or more and those with a left ventricular ejection fraction of less than 60%, and results were similar in prespecified subgroups, including patients with or without diabetes. The incidence of adverse events was similar in the two groups. CONCLUSIONS: Dapagliflozin reduced the combined risk of worsening heart failure or cardiovascular death among patients with heart failure and a mildly reduced or preserved ejection fraction. (Funded by AstraZeneca; DELIVER ClinicalTrials.gov number, NCT03619213.).

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  • McMurray, John J. V. (author)
  • Claggett, Brian (author)
  • de Boer, Rudolf A. (author)
  • DeMets, David (author)
  • Hernandez, Adrian F. (author)
  • Inzucchi, Silvio E. (author)
  • Kosiborod, Mikhail N. (author)
  • Lam, Carolyn S. P. (author)
  • Martinez, Felipe (author)
  • Shah, Sanjiv J. (author)
  • Desai, Akshay S. (author)
  • Jhund, Pardeep S. (author)
  • Belohlavek, Jan (author)
  • Chiang, Chern-En (author)
  • Borleffs, C. Jan Willem (author)
  • Comin-Colet, Josep (author)
  • Dobreanu, Dan (author)
  • Drozdz, Jaroslaw (author)
  • Fang, James C. (author)
  • Alcocer-Gamba, Marco Antonio (author)
  • Al Habeeb, Waleed (author)
  • Han, Yaling (author)
  • Cabrera Honorio, Jose Walter (author)
  • Janssens, Stefan P. (author)
  • Katova, Tzvetana (author)
  • Kitakaze, Masafumi (author)
  • Merkely, Bela (author)
  • O’Meara, Eileen (author)
  • Saraiva, Jose Francisco Kerr (author)
  • Tereshchenko, Sergey N. (author)
  • Thierer, Jorge (author)
  • Vaduganathan, Muthiah (author)
  • Vardeny, Orly (author)
  • Verma, Subodh (author)
  • Pham, Vinh Nguyen (author)
  • Wilderang, Ulrica (author)
  • Zaozerska, Natalia (author)
  • Bachus, Erasmus (author)
  • Lindholm, Daniel (author)
  • Petersson, Magnus (author)
  • Langkilde, Anna Maria (author)

Related titles

  • In:The New England journal of medicine387:12, s. 1089-1098

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