In patients with heart failure with reduced ejection fraction (HFrEF), the benefit of dapagliflozin therapy is independent of the degree to which left ventricular ejection fraction (LVEF) is reduced. This finding comes from a post-hoc analysis of the DAPA-HF trial. A total of 4,744 patients with HFrEF and a LVEF ≤40% were randomly assigned to dapagliflozin (10 mg once daily) or placebo. The extent of the reduction in LVEF was a significant predictor of hospitalization for heart failure and cardiovascular mortality. The reduction in the primary end point (worsening heart failure event or cardiovascular death) with dapagliflozin treatment was consistent regardless of LVEF (HR 0.75, 0.75, 0.67 and 0.83 for LVEF <26%, 26–30%, 31–35% and >35%, respectively; P = 0.762 for interaction). The efficacy of dapagliflozin was also independent of whether or not patients had diabetes mellitus.
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Dewan, P. et al. Efficacy and safety of sodium–glucose co-transporter 2 inhibition according to left ventricular ejection fraction in DAPA-HF. Eur. J. Heart Fail. https://doi.org/10.1002/ejhf.1867 (2020)
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Lim, G.B. Benefit of dapagliflozin is independent of LVEF. Nat Rev Cardiol 17, 540 (2020). https://doi.org/10.1038/s41569-020-0419-3
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DOI: https://doi.org/10.1038/s41569-020-0419-3