Effect of Dapagliflozin in DAPA-HF According to Background Glucose-Lowering Therapy
Kieran F. Docherty, Pardeep S. Jhund, Olof Bengtsson, David L. DeMets, Silvio E. Inzucchi, Lars Køber, Mikhail Kosiborod, Anna Maria Langkilde, Felipe A. Martínez, Marc S. Sabatine, Mikaela Sjöstrand, Scott D. Solomon, John J.V. McMurray, Mirta Díez, Sonia A Sassone, Diego Aizenberg, María L. Talavera, Guillermo Mercau, Diego Martinez, Juan Pablo Albisu, Alejandro Hershson, Rubén GarcíaDurán, Miguel Hominal, Natalia Cluigt, Fernando ColomboBerra, Eduardo Perna, Rodolfo AhuadGuerrero, Daniela GarcíaBrasca, Cesar Javier Zaidman, Claudio Majul, José Taborda, Hugo A Luquez, Jorgelina Sala, Alvaro SosaLiprandi, Guillermo Cursack, Oscar Montaña, AlbertoAlfredo Fernandez, Martín Najenson, S Nani, G Caruso, Enrique Fairman, Stella PereiroGonzalez, Lília Nigro Maia, Adamastor Humberto Pereira, Paulo Roberto Ferreira ROSSI, Dalton Bertolim Précoma, Fernando Carvalho Neuenschwander, Gilmar Reis, Fabio Augusto Bronzi Guimarães, José Francisco Kerr Saraiva, Flavia Arantes, Mauro Esteves Hernandes, João Carlos de Oliveira Borges, Bruno Paolino, Eduardo Vasconcellos, Euler Roberto Fernandes Manenti, Pedro Pimentel, Paulo Leães, Salvador Rassi, Talia Falcão Dalçóquio, Tsvetana Katova, D Avramov, Nataliya Spasova, Dimitar Raev, Boryana Chompalova, Maria Milanova, Maria Tokmakova, N. Runev, Atanas Mihov, Antoni Gogov, Adriana Dincheva, Nikolay Iliev, Borislav Kolomanov, Yuliyana Ivanova, Katya Ilieva, Dimitar Karageorgiev, Ivan Petrov, Nikolay Botushanov, S Vladeva, Christian Constance, Saul Vizel, A. Shekhar Pandey, Denis-Carl Phaneuf, Shamir R. Mehta, Dennis Rupka, Yves Pesant, Paul Poirier, R Chehayeb, Mohan Babapulle, Eileen O’Meara, Jonathan G. Howlett, Louis Yao, Robert S. McKelvie, Subodh Verma, Michael Hartleib, Ram Vijayaraghavan, John Vyselaar, Fabián Azzari, James Cha, Farah Nasser-Sharif
Abstract
OBJECTIVE To determine whether the benefits of dapagliflozin in patients with heart failure and reduced ejection fraction (HFrEF) and type 2 diabetes in the Dapagliflozin And Prevention of Adverse-Outcomes in Heart Failure trial (DAPA-HF) varied by background glucose-lowering therapy (GLT). RESEARCH DESIGN AND METHODS We examined the effect of study treatment by the use or not of GLT and by GLT classes and combinations. The primary outcome was a composite of worsening heart failure (hospitalization or urgent visit requiring intravenous therapy) or cardiovascular death. RESULTS In the 2,139 type 2 diabetes patients, the effect of dapagliflozin on the primary outcome was consistent by GLT use or no use (hazard ratio 0.72 [95% CI 0.58–0.88] vs. 0.86 [0.60–1.23]; interaction P = 0.39) and across GLT classes. CONCLUSIONS In DAPA-HF, dapagliflozin improved outcomes irrespective of use or no use of GLT or by GLT type used in patients with type 2 diabetes and HFrEF.