Dapagliflozin Lowers Risk for Worsening Heart Failure

For patients with heart failure and reduced ejection fraction, dapagliflozin is associated with a lower risk for worsening heart failure or death from cardiovascular causes, regardless of the presence of type 2 diabetes, according a study published online Sept. 19 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the European Association for the Study of Diabetes.

John J.V. McMurray, M.D., from the University of Glasgow in the United Kingdom, and colleagues randomly assigned 4,744 patients with New York Heart Association class II, III, or IV heart failure and an ejection fraction of 40 percent or less to receive either dapagliflozin (2,373 patients) or placebo (2,371 patients) in addition to recommended therapy.

The researchers found that the primary outcome of worsening heart failure or cardiovascular death occurred in 16.3 and 21.2 percent of patients in the dapagliflozin and placebo groups, respectively, during a median of 18.2 months (hazard ratio, 0.74). A first worsening heart failure event occurred in 10.0 and 13.7 percent, respectively (hazard ratio, 0.70). Death from cardiovascular causes occurred in 9.6 and 11.5 percent of patients in the dapagliflozin and placebo groups, respectively (hazard ratio, 0.82), while 11.6 and 13.9 percent, respectively, died from any cause (hazard ratio, 0.83). Findings were similar for patients with and without diabetes.

"Dapagliflozin was as effective in the 55 percent of patients without type 2 diabetes as in those with diabetes," the authors write.

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