posted on 2020-09-03, 00:29authored byKieran F. Docherty, Pardeep S. Jhund, Olof Bengtsson, David L. DeMets, Silvio E. Inzucchi, Lars Køber, Mikhail N. Kosiborod, Anna Maria Langkilde, Felipe A. Martinez, Marc S. Sabatine, Mikaela Sjöstrand, Scott D. Solomon, John J.V. McMurray, the DAPA-HF Investigators and Committees
Objective: To determine whether the benefits of
dapagliflozin in patients with heart failure and reduced ejection fraction (HFrEF)
and type 2 diabetes in 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 HF (hospitalization or urgent visit requiring intravenous
therapy) or cardiovascular death.
Results: In the 2139 type 2 diabetes
patients, the effect of dapagliflozin on the primary outcome was consistent by
GLT use/no use (hazard ratio 0.72 [95%CI 0.58-0.88] versus 0.86 [0.60-1.23];
P-interaction=0.39) and across GLT classes.
Conclusions: In DAPA-HF, dapagliflozin
improved outcomes irrespective of use/no use of GLT or by GLT type used in patients
with type 2 diabetes and HFrEF.
Funding
The DAPA-HF trial was funded by AstraZeneca. Prof McMurray is supported by a British Heart Foundation Centre of Research Excellence Grant RE/18/6/34217.