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WFRF:(Dukat Andre)
 

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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004772naa a2200721 4500
001oai:DiVA.org:uu-512636
003SwePub
008240522s2022 | |||||||||||000 ||eng|
009oai:gup.ub.gu.se/318234
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-5126362 URI
0247 a https://doi.org/10.1002/ejhf.26492 DOI
0247 a https://gup.ub.gu.se/publication/3182342 URI
040 a (SwePub)uud (SwePub)gu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Adamson, Carly4 aut
2451 0a Liver Tests and Outcomes in Heart Failure with Reduced Ejection Fraction :b Findings from DAPA-HF.
264 c 2022-08-22
264 1b Wiley,c 2022
338 a print2 rdacarrier
520 a AIMS: Reflecting both increased venous pressure and reduced cardiac output, abnormal liver tests are common in patients with severe heart failure and are associated with adverse clinical outcomes. We aimed to investigate the prognostic significance of abnormal liver tests in ambulatory patients with heart failure with reduced ejection fraction (HFrEF), explore any treatment interaction between bilirubin and sodium- glucose cotransporter 2 (SGLT2) inhibitors and examine change in liver tests with SGLT2 inhibitor treatment. METHODS AND RESULTS: We explored these objectives in the Dapagliflozin And Prevention of Adverse outcomes in Heart Failure (DAPA-HF) trial, with focus on bilirubin. We calculated the incidence of cardiovascular death or worsening heart failure by bilirubin tertile. Secondary cardiovascular outcomes were examined, along with the change in liver tests at the end-of-study visit. Baseline bilirubin was available in 4720 patients (99.5%). Participants in the highest bilirubin tertile (T3) have more severe HFrEF (lower left ventricular ejection fraction, higher N-terminal pro-B-type natriuretic peptide [NT-proBNP] and worse New York Heart Association class), had a greater burden of atrial fibrillation but less diabetes. Higher bilirubin (T3 vs. T1) was associated with worse outcomes even after adjustment for other predictive variables, including NT-proBNP and troponin T (adjusted hazard ratio for the primary outcome 1.73 [95% confidence interval 1.37-2.17], p $<$ 0.001; and 1.52 [1.12-2.07], p = 0.01 for cardiovascular death). Baseline bilirubin did not modify the benefits of dapagliflozin. During follow-up, dapagliflozin had no effect on liver tests. CONCLUSION: Bilirubin concentration was an independent predictor of worse outcomes but did not modify the benefits of dapagliflozin in HFrEF. Dapagliflozin was not associated with change in liver tests. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT03036124.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653 a *Heart Failure
653 a Alkaline phosphatase
653 a Bilirubin
653 a Dapagliflozin
653 a Heart failure
653 a Hepatic function
653 a Humans
653 a Liver
653 a SGLT2 inhibitor
653 a Stroke Volume
653 a Ventricular Function
653 a Left
7001 a Cowan, Lorna M.4 aut
7001 a de Boer, Rudolf A.4 aut
7001 a Diez, Mirta4 aut
7001 a Drozdz, Jaroslaw4 aut
7001 a Dukat, Andre4 aut
7001 a Inzucchi, Silvio E.4 aut
7001 a Kober, Lars4 aut
7001 a Kosiborod, Mikhail N.4 aut
7001 a Ljungman, Charlotta,d 1977u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine4 aut0 (Swepub:gu)xljcha
7001 a Martinez, Felipe A.4 aut
7001 a Ponikowski, Piotr4 aut
7001 a Sabatine, Marc S.4 aut
7001 a Lindholm, Daniel4 aut
7001 a Bengtsson, Olof4 aut
7001 a Boulton, David W.4 aut
7001 a Greasley, Peter J.4 aut
7001 a Langkilde, Anna Maria4 aut
7001 a Sjostrand, Mikaela4 aut
7001 a Solomon, Scott D.4 aut
7001 a McMurray, John J. V.4 aut
7001 a Jhund, Pardeep S.4 aut
7102 a Göteborgs universitetb Institutionen för medicin, avdelningen för molekylär och klinisk medicin4 org
7730 t European journal of heart failured : Wileyg 24:10, s. 1856-1868q 24:10<1856-1868x 1388-9842x 1879-0844
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512636
8564 8u https://doi.org/10.1002/ejhf.2649
8564 8u https://gup.ub.gu.se/publication/318234

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