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Peikert, A; Vaduganathan, M; Claggett, BL; Kulac, IJ; Foà, A; Desai, AS; Jhund, PS; Carberry, J; Lam, CSP; Kosiborod, MN; Inzucchi, SE; Martinez, FA; de, Boer, RA; Hernandez, AF; Shah, SJ; Køber, L; Ponikowski, P; Sabatine, MS; Petersson, M; Langkilde, AM; McMurray, JJV; Solomon, SD.
Dapagliflozin in patients with heart failure and previous myocardial infarction: A participant-level pooled analysis of DAPA-HF and DELIVER.
Eur J Heart Fail. 2024; 26(4):912-924 Doi: 10.1002/ejhf.3184
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Leading authors Med Uni Graz: Peikert Alexander
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Abstract:: AIMS: Patients with heart failure (HF) and history of myocardial infarction (MI) face a higher risk of disease progression and clinical events. Whether sodium-glucose cotransporter 2 inhibitors may modify clinical trajectory in such individuals remains incompletely understood. METHODS AND RESULTS: The DAPA-HF and DELIVER trials compared dapagliflozin with placebo in patients with symptomatic HF with left ventricular ejection fraction (LVEF) ≤40% and > 40%, respectively. In this pooled participant-level analysis, we assessed efficacy and safety outcomes by history of MI. The primary outcome in both trials was the composite of cardiovascular death or worsening HF. Of the total of 11 007 patients, 3731 (34%) had a previous MI and were at higher risk of the primary outcome across the spectrum of LVEF in covariate-adjusted models (hazard ratio [HR] 1.12, 95% confidence interval [CI] 1.02-1.24). Dapagliflozin reduced the risk of the primary outcome to a similar extent in patients with (HR 0.83, 95% CI 0.72-0.96) and without previous MI (HR 0.76, 95% CI 0.68-0.85; p_interaction = 0.36), with consistent benefits on key secondary outcomes as well. Serious adverse events did not occur more frequently with dapagliflozin, irrespective of previous MI. CONCLUSION: History of MI confers increased risks of adverse cardiovascular outcomes in patients with HF across the LVEF spectrum, even among those with preserved ejection fraction. Dapagliflozin consistently and safely reduces the risk of cardiovascular death or worsening HF, regardless of previous MI.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; Heart Failure - drug therapy, physiopathology; Glucosides - therapeutic use, administration & dosage; Benzhydryl Compounds - therapeutic use; Myocardial Infarction - drug therapy; Male - administration & dosage; Female - administration & dosage; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Stroke Volume - physiology; Aged - administration & dosage; Middle Aged - administration & dosage; Treatment Outcome - administration & dosage; Disease Progression - administration & dosage; Ventricular Function, Left - physiology, drug effects; Double-Blind Method - administration & dosage
Find related publications in this database (Keywords): Myocardial infarction; Heart failure with reduced ejection fraction; Heart failure with mildly reduced ejection fraction; Heart failure with preserved ejection fraction; SGLT2 inhibitors