Patient Characteristics, Outcomes, and Effects of Dapagliflozin According to the Duration of Heart Failure: A Prespecified Analysis of the DELIVER Trial
Circulation 2023; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.062918
Whether the efficacy and safety of SGLT2i therapy are maintained with increasing duration of HFmrEF or HFpEF is unknown. In this prespecified analysis of DELIVER, HF duration was categorised as ≤6 months, >6 to 12 months, >1 to 2 years, >2 to 5 years, or >5 years.
Patients with longer-duration HF were older and had more comorbidities with worse symptoms. Furthermore, the rate of the primary outcome, the composite of worsening HF or CV death, increased with HF duration. However, the benefits of dapagliflozin, compared with placebo, on clinical outcomes and health status were consistent regardless of the duration of HF. AEs were not more common in patients on dapagliflozin compared with placebo, irrespective of the duration of HF.
The authors concluded that even patients with long-standing HF and generally mild symptoms are not “stable” and an SGLT2i should be considered.