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Atrial Fibrillation...
Atrial Fibrillation and Dapagliflozin Efficacy in Patients With Preserved or Mildly Reduced Ejection Fraction.
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Butt, Jawad H. (author)
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Kondo, Toru (author)
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Jhund, Pardeep S. (author)
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Comin-Colet, Josep (author)
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de Boer, Rudolf A. (author)
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Desai, Akshai S. (author)
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Hernandez, Adrian F. (author)
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Inzucchi, Silvio E. (author)
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Janssens, Stefan P. (author)
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Kosiborod, Mikhail N. (author)
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Lam, Carolyn S. P. (author)
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Langkilde, Anna Maria (author)
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Lindholm, Daniel (author)
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Martinez, Felipe (author)
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Petersson, Magnus (author)
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Shah, Sanjiv J. (author)
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Thierer, Jorge (author)
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Vaduganathan, Muthiah (author)
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Verma, Subodh (author)
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Wilderang, Ulrica (author)
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Claggett, Brian C. (author)
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Solomon, Scott D. (author)
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McMurray, John J. V. (author)
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- Elsevier BV, 2022
- 2022
- English.
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In: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097. ; 80:18, s. 1705-1717
- 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
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- BACKGROUND: Atrial fibrillation (AF) is common in heart failure (HF), is associated with worse outcomes compared with sinus rhythm, and may modify the effects of therapy. OBJECTIVES: This study examined the effects of dapagliflozin according to the presence or not of AF in the DELIVER (Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure) trial. METHODS: A total of 6,263 patients with HF with New York Heart Association functional class II-IV, left ventricular ejection fraction $>$40%, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomized to dapagliflozin or placebo. Clinical outcomes and the effect of dapagliflozin, according to AF status, were examined. The primary outcome was a composite of cardiovascular death or worsening HF. RESULTS: Of the 6,261 patients with data on baseline AF, 43.3% had no AF, 18.0% had paroxysmal AF, and 38.7% had persistent/permanent AF. The risk of the primary endpoint was higher in patients with AF, especially paroxysmal AF, driven by a higher rate of HF hospitalization: no AF, HF hospitalization rate per 100 person-years (4.5 [95% CI: 4.0-5.1]), paroxysmal AF (7.5 [95% CI: 6.4-8.7]), and persistent/permanent AF (6.4 [95% CI: 5.7-7.1]) (P $<$ 0.001). The benefit of dapagliflozin on the primary outcome was consistent across AF types: no AF, HR: 0.89 (95% CI: 0.74-1.08); paroxysmal AF, HR: 0.75 (95% CI: 0.58-0.97); persistent/permanent AF, HR: 0.79 (95% CI: 0.66-0.95) (Pinteraction = 0.49). Consistent effects were observed for HF hospitalization, cardiovascular death, all-cause mortality, and improvement in the KCCQ- TSS. CONCLUSIONS: In DELIVER, the beneficial effects of dapagliflozin compared with placebo on clinical events and symptoms were consistent, irrespective of type of AF at baseline. (Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure. [DELIVER]; NCT03619213).
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- *Atrial Fibrillation/complications
- *Heart Failure
- *Ventricular Dysfunction
- Left/complications
- atrial fibrillation
- clinical trial
- heart failure
- Humans
- outcomes
- Stroke Volume
- Ventricular Function
- Left
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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Kondo, Toru
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Jhund, Pardeep S ...
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Comin-Colet, Jos ...
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de Boer, Rudolf ...
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Desai, Akshai S.
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show more...
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Hernandez, Adria ...
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Inzucchi, Silvio ...
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Janssens, Stefan ...
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Kosiborod, Mikha ...
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Lam, Carolyn S. ...
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Langkilde, Anna ...
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Lindholm, Daniel
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Martinez, Felipe
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Petersson, Magnu ...
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Shah, Sanjiv J.
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Thierer, Jorge
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Vaduganathan, Mu ...
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Verma, Subodh
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Wilderang, Ulric ...
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Claggett, Brian ...
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Solomon, Scott D ...
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McMurray, John J ...
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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 ...
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Journal of the A ...
- By the university
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Uppsala University