https://doi.org/10.55788/dc8527fa
âWhether sodium-glucose cotransporter-2 (SGLT2) inhibitors consistently improve the symptoms and physical limitations across the entire range of LVEF in patients with HF is not well established,â explained Dr Mikhail Kosiborod (St. Lukeâs Hospital, MO, USA) [1]. Therefore, a pooled analysis of the DEFINE-HF trial (NCT02653482), including 263 patients with LVEF â€40%, and the PRESERVED-HF trial (NCT03030235), including 324 patients with LVEF â„45%, was conducted to assess this matter [2,3]. In both trials, the Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical summary score (CSS) at week 12 was the primary endpoint.
After 12 weeks, patients on dapagliflozin displayed an improvement of 5.0 points on the KCCQ-CSS compared with placebo (P<0.0001). Importantly, this result was consistent across LVEF subgroups (Pinteraction=0.79). The corresponding mean changes in KCCQ-CSS score were 4.57, 4.91, and 6.77 for patients with LVEF â€40%, >40% to <60%, and â„60%, respectively. This result was consistent when it was measured on a continuous scale (see Figure). Similar consistent results were obtained for other KCCQ domains.
âThese results support the use of dapagliflozin in patients with HF, regardless of EF,â concluded Dr Kosiborod.
Figure: Effect of dapagliflozin versus placebo on KCCQ-CSS across LVEF [1]
LVEF, left ventricular ejection fraction.
- Kosiborod M, et al. DEFINE-HF and PRESERVED-HF: Dapagliflozin improves heart failure symptoms and physical limitations across the entire range of LVEF. LBT Pharmacological treatment I, Heart Failure 2022, 21â24 May, Madrid, Spain.
- Nassif ME, et al. Circulation 2019;140(18):1463â1476.
- Nassif ME, et al. Nat Med 2021;27(11):1954â1960.
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Table of Contents: HFA 2022
Featured articles
Phase 3 and 4 Trials
GALACTIC-HF: Omecamtiv mecarbil as option for HFrEF patients with low SBP
HELIOS-A: Vutrisiran meets exploratory endpoints
Patiromer helps HFrEF patients to optimise RAAS inhibitors without hyperkalaemia
FIDELITY: Cardiorenal benefits of finerenone, regardless of LVH status
DAPA-VO2: Rapid effect of dapagliflozin on peak VO2 in stable HFrEF
Phase 1/2 Trials
Significant improvement in BP from istaroxime, a novel non-adrenergic agent
SERENADE: Macitentan fails in HFpEF plus PAH
Combination of filgrastim and dutogliptin appears safe in STEMI
Therapeutic Devices
Cardiac contractility modulation therapy promising for patients with HFpEF
REBALANCE-HF: Encouraging observations for splanchnic nerve ablation in HFpEF
Updates on SGLT2 Inhibitors
DAPA-HF: Dapagliflozin is safe and efficacious in frail patients
EMPEROR-Preserved: Empagliflozin stable across age groups
EMPULSE: Empagliflozin delivers rapid and clinically meaningful decongestion
Dapagliflozin performs consistently across LVEF in HF
Miscellaneous Topics
Cardiac wasting relevant for clinical outcomes in cancer
Urocortin-2 a potential treatment target for HFpEF
Should ATTR-CM be added to the differential diagnosis of patients with HF?
Delayed initiation of novel GDMTs associated with adverse outcomes in HF patients
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