Dapagliflozin Cuts CV Risk in Heart Failure With Preserved LVEF

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Risk reduced for primary outcome of worsening heart failure or cardiovascular death

MONDAY, Aug. 29, 2022 (HealthDay News) — For patients with heart failure with mildly reduced or preserved ejection fraction, the sodium glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin reduces the combined risk for worsening heart failure or cardiovascular death, according to a study published online Aug. 27 in the New England Journal of Medicine to coincide with the European Society of Cardiology Congress 2022, held from Aug. 26 to 29 in Barcelona, Spain.

Scott D. Solomon, M.D., from Brigham and Women’s Hospital in Boston, and colleagues randomly assigned 6,263 patients with heart failure and a left ventricular ejection fraction of more than 40 percent to receive either dapagliflozin or matching placebo, in addition to usual therapy. The primary outcome, assessed in a time-to-event analysis, was a composite of worsening heart failure or cardiovascular death.

The researchers found that the primary outcome occurred in 16.4 percent of 3,131 patients in the dapagliflozin group and in 19.5 percent of 3,132 patients in the placebo group (hazard ratio, 0.82; 95 percent confidence interval, 0.73 to 0.92; P < 0.001). Worsening heart failure occurred in 11.8 and 14.5 percent of patients in the dapagliflozin and placebo groups, respectively (hazard ratio, 0.79; 95 percent confidence interval, 0.69 to 0.91), and cardiovascular death occurred in 7.4 and 8.3 percent, respectively (hazard ratio, 0.88; 95 percent confidence interval, 0.74 to 1.05). Compared with the placebo group, total events and symptom burden were both lower in the dapagliflozin group.

“These data provide further evidence to support the use of an SGLT2 inhibitor as essential therapy in patients with heart failure, regardless of the presence or absence of type 2 diabetes mellitus or left ventricular ejection fraction,” the authors write.

The study was funded by AstraZeneca, the manufacturer of dapagliflozin.

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