JAMA cardiology

How Quickly Dapagliflozin Helps Patients with Heart Failure and Mildly Reduced or Normal Heart Pumping

Updated

Abstract

In a trial with 6263 patients, dapagliflozin was associated with significant reductions in cardiovascular death or worsening heart failure events within 13 days of treatment initiation.

  • Dapagliflozin showed a hazard ratio of 0.45 for the primary composite endpoint of cardiovascular death or worsening heart failure, indicating a 55% reduction in risk.
  • Significant benefits for worsening heart failure events were observed with a hazard ratio of 0.45, suggesting early effectiveness.
  • Sustained statistical significance for both primary and worsening heart failure endpoints was maintained at various follow-up points, including 30 days and 2 years.
  • The incidence rate for the primary endpoint was 8.7 events per 100 patient-years during a median follow-up of 2.3 years.
  • The study included a diverse population, with 43.9% of participants being women and a mean age of 71.7 years.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr Vaduganathan has received personal fees from Amgen, AstraZeneca, Baxter HealthCare, Bayer, Boehringer Ingelheim, Cytokinetics, Relypsa, American Regent, Novartis, Roche Diagnostics, Lexicon Pharmaceuticals, Galmed, Occlutech, Impulse Dynamics, Pharmacosmos, Sanofi, and Tricog Health outside the submitted work. Dr Claggett has received personal fees from Boehringer Ingelheim, Cardurion, Corvia, and Novartis outside the submitted work. Dr Jhund has received grants from the British Heart Foundation and research support from AstraZeneca paid to his employer during the conduct of the study; research support from Novartis, Bayer, and Novo Nordisk paid to his employer; and personal fees from Boehringer Ingelheim outside the submitted work. Dr de Boer has received grants from Abbott, AstraZeneca, Boehringer Ingelheim, Cardior Pharmaceuticals, Ionis Pharmaceuticals, Novo Nordisk, and Roche paid to his institution and personal fees from Abbott, AstraZeneca, Bayer, Novartis, and Roche during the conduct of the study. Dr Hernandez has received personal fees from AstraZeneca during the conduct of the study; grants from AstraZeneca, American Regent, and Verily; and personal fees from Amgen, Bayer, Boehringer Ingelheim, Boston Scientific, Biofourmis, Cytokinetics, Merck, Bristol Myers Squibb, Somologic, Novo Nordisk, and Novartis outside the submitted work. Dr Inzucchi has received personal fees from AstraZeneca during the conduct of the study; personal fees from AstraZeneca, Novo Nordisk, Lexicon, vTv Therapeutics, Merck/Pfizer, Esperion, and Abbott; and nonfinancial support from Boehringer Ingelheim outside the submitted work. Dr Kosiborod has received grants from AstraZeneca and Boehringer Ingelheim as well as personal fees from AstraZeneca, Boehringer Ingelheim, Alnylam, Amgen, Applied Therapeutics, Bayer, Cytokinetics, Eli Lilly, Esperion Therapeutics, Janssen, Lexicon, Merck, Novo Nordisk, Pharmacosmos, Sanofi, and Vifor Pharma outside the submitted work. Dr Lam has received grants from National Medical Research Council of Singapore, Bayer, and Roche Diagnostics as well as personal fees from Abbott, Actelion, Alleviant Medical, Allysta Pharma, Amgen, AnaCardio AB, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Cytokinetics, Darma, EchoNous, Eli Lilly, Impulse Dynamics, Ionis Pharmaceutical, Janssen Research & Development, Medscape/WebMD Global, Merck, Novartis, Novo Nordisk, Prosciento, Radcliffe Group, Roche Diagnostics, Sanofi, Siemens Healthcare Diagnostics, and Us2.ai outside the submitted work; has patent PCT/SG2016/050217 pending and patent 10,702,247 issued; and is cofounder and a director of Us2.ai. Dr Martinez has received personal fees from AstraZeneca during the conduct of the study as well as grants from Novartis and Milestone and personal fees from Bayer, Gador, and Bago outside the submitted work. Dr Shah has received personal fees from AstraZeneca during the conduct of the study as well as grants from the National Institutes of Health, Actelion, AstraZeneca, Corvia, Novartis, and Pfizer and personal fees from Abbott, Actelion, AstraZeneca, Amgen, Aria CV, Axon Therapies, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardiora, Coridea, CVRx, Cyclerion, Cytokinetics, Edwards Lifesciences, Eidos, Eisai, Imara, Impulse Dynamics, Intellia, Ionis, Ironwood, Lilly, Merck, MyoKardia, Novartis, Novo Nordisk, Pfizer, Prothena, Regeneron, Rivus, Sanofi, Shifamed, Tenax, Tenaya, and United Therapeutics outside the submitted work. Dr Desai has received grants from the British Heart Foundation Centre and AstraZeneca paid to his institution and personal fees from AstraZeneca during the conduct of the study as well as grants from Abbott , Alnylam, Bayer, and Novartis paid to his institution and personal fees from Abbott, Alnylam, Amgen, Avidity, Bayer, Boston Scientific, Biofourmis, Axon Therapeutics, Cytokinetics, GlaxoSmithKline, Medpace, Merck, Novartis, Parexel, Regeneron, Roche, Verily, and NewAmersterdam outside the submitted work. Dr Hegde has received research payments paid to her institution from Bristol Myers Squibb outside the submitted work. Dr McMurray has received consulting fees from AstraZeneca paid to his institution during the conduct of the study as well as consulting fees from Bayer, Amgen, Servier, Theracos, Dalcor, GlaxoSmithKline, Bristol Myers Squibb, Alnylam, Ionis Pharmaceuticals, Cardurion, Boehringer Ingelheim, and Novartis paid to his institution and personal fees from Abbott, Alkem Metabolics, Eris Lifesciences, Hikma, Lupin, Sun Pharmaceuticals, Medscape/Heart.Org, ProAdWise Communications, Radcliffe Cardiology, Servier, and Corpus outside the submitted work. Dr Solomon has received grants from AstraZeneca paid to his institution during the conduct of the study as well as grants from Actelion, Alnylam, Amgen, AstraZeneca, Bellerophon, Bayer, Bristol Myers Squibb, Celladon, Cytokinetics, Eidos, Gilead, GlaxoSmithKline, Ionis, Lilly, Mesoblast, MyoKardia, the National Heart, Lung, and Blood Institute, Neurotronik, Novartis, Novo Nordisk, Respicardia, Sanofi Pasteur, Theracos, and Us2.ai paid to his to institution and personal fees from Abbott, Action, Akros, Alnylam, Amgen, Arena, AstraZeneca, Bayer, Boeringer Ingelheim, Bristol Myers Squibb, Cardior, Cardurion, Corvia, Cytokinetics, Daiichi-Sankyo, GlaxoSmithKline, Eli Lilly, Merck, MyoKardia, Novartis, Roche, Theracos, Quantum Genomics, Cardurion, Janssen, Cardiac Dimensions, Tenaya, Sanofi-Pasteur, Dinaqor, Tremeau, CellProThera, Moderna, American Regent, Sarepta, Lexicon, Anacardio, Akros, and Puretech Health outside the submitted work. No other disclosures were reported.
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