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.
Efficacy and Safety of Dapagliflozin in Patients with Heart Failure with Mildly Reduced or Preserved Ejection Fraction by Baseline Glycaemic Status (DELIVER): a Subgroup Analysis from an International, Multicentre, Double-blind, Randomised, Placebo-controlled Trial
Lancet Diabetes Endocrinol. 2022;10:869–881 DOI: 10.1016/S2213-8587(22)00308-4
Dapagliflozin was shown to be highly efficacious in patients with HFmrEF and HFpEF in the DELIVER trial. However, whether the benefits of dapagliflozin are observed across glycaemia categories has not been previously reported.
Time to Clinical Benefit of Dapagliflozin in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Secondary Analysis of the DELIVER Randomized Clinical Trial
JAMA Cardiol. 2022; online ahead of print DOI: 10.1001/jamacardio.2022.3750
Dapagliflozin was recently shown to reduce CV death or worsening HF events in patients with HF with mildly reduced or preserved ejection fraction in the DELIVER trial. This prespecified secondary analysis of DELIVER examined the timeline to onset of clinical benefit with dapagliflozin.
Dapagliflozin in Patients Recently Hospitalized With Heart Failure and Mildly Reduced or Preserved Ejection Fraction
J Am Coll Cardiol. 2022; online ahead of print DOI: 10.1016/j.jacc.2022.07.021
This prespecified analysis of the DELIVER trial found that dapagliflozin had beneficial effects on cardiovascular (CV) outcomes in patients with heart failure (HF) with mildly reduced or preserved left ventricular ejection fraction (LVEF) who were enrolled during or following hospitalisation.
Dapagliflozin across the range of ejection fraction in patients with heart failure: a patient-level, pooled meta-analysis of DAPA-HF and DELIVER
Nat Med. 2022; online ahead of print DOI: 10.1038/s41591-022-01971-4
In a prospective, patient-level pooled meta-analysis of the DAPA-HF and DELIVER trials, dapagliflozin was found to improve clinical outcomes across the range of LVEF.
Randomized Controlled Trial of the Hemodynamic Effects of Empagliflozin in Patients With Type 2 Diabetes at High Cardiovascular Risk: The SIMPLE Trial
Diabetes 2022;71:812–20 doi.org/10.2337/db21-0721
In this analysis of data from the SIMPLE trial, empagliflozin did not reduce left heart filling pressure more than placebo at submaximal exercise in patients with T2D at high CV risk. However, it was observed that empagliflozin reduced pulmonary capillary wedge pressure (PCWP) at a magnitude of clinical significance in patients at rest. The findings suggest cardiac benefits beyond the diuretic effect of sodium-glucose co-transporter-2 inhibitor (SGLT2i) treatment and could explain a significant part of the CV benefits observed in clinical trials.
Initial Decline (“Dip”) in Estimated Glomerular Filtration Rate Following Initiation of Dapagliflozin in Patients With Heart Failure and Reduced Ejection Fraction: Insights From DAPA-HF
Circulation 2022; Online ahead of print doi: 10.1161/CIRCULATIONAHA.121.058910
The results of this subgroup analysis from DAPA-HF show that – although estimated glomerular filtration rate (eGFR) decline is generally associated with poorer prognosis in most situations – an initial dip with a sodium-glucose co-transporter-2 inhibitor (SGLT2i) may be associated with slower rate of decline in kidney function.
Effects of Empagliflozin on Markers of Liver Steatosis and Fibrosis and Their Relationship to Cardiorenal Outcomes
Diabetes Obes Metab 2022; doi:10.1111/dom.14670
In this study of adults with T2D and established CV disease, the proportion of patients at high steatosis risk decreased slightly in patients treated with empagliflozin compared with patients treated with placebo. Fibrosis risk was not reduced.
Dapagliflozin and New-Onset Type 2 Diabetes in Patients With Chronic Kidney Disease Or Heart Failure: Pooled Analysis of the DAPA-CKD and DAPA-HF Trials
Lancet Diabetes Endocrinol 2022;10:24–34 doi.org/10.1016/
Chronic kidney disease and heart failure are insulin resistant states associated with high incidence rates of diabetes. Rossing et al. carried out a two Phase 3, randomised, double-blind, placebo-controlled trials assessed the effect of dapagliflozin on new-onset type 2 diabetes, in a pooled analysis of data from 6,608 individuals.