Journal article
The SGLT2 inhibitor dapagliflozin in heart failure with preserved ejection fraction: a multicenter randomized trial
Nature medicine, v 27(11), pp 1954-1960
01 Nov 2021
PMID: 34711976
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Patients with heart failure and preserved ejection fraction (HFpEF) have a high burden of symptoms and functional limitations, and have a poor quality of life. By targeting cardiometabolic abmormalities, sodium glucose cotransporter 2 (SGLT2) inhibitors may improve these impairments. In this multicenter, randomized trial of patients with HFpEF (NCT03030235), we evaluated whether the SGLT2 inhibitor dapagliflozin improves the primary endpoint of Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CS), a measure of heart failure-related health status, at 12 weeks after treatment initiation. Secondary endpoints included the 6-minute walk test (6MWT), KCCQ Overall Summary Score (KCCQ-OS), clinically meaningful changes in KCCQ-CS and -OS, and changes in weight, natriuretic peptides, glycated hemoglobin and systolic blood pressure. In total, 324 patients were randomized to dapagliflozin or placebo. Dapagliflozin improved KCCQ-CS (effect size, 5.8 points (95% confidence interval (CI) 2.3-9.2, P = 0.001), meeting the predefined primary endpoint, due to improvements in both KCCQ total symptom score (KCCQ-TS) (5.8 points (95% CI 2.0-9.6, P = 0.003)) and physical limitations scores (5.3 points (95% CI 0.7-10.0, P = 0.026)). Dapagliflozin also improved 6MWT (mean effect size of 20.1 m (95% CI 5.6-34.7, P = 0.007)), KCCQ-OS (4.5 points (95% CI 1.1-7.8, P = 0.009)), proportion of participants with 5-point or greater improvements in KCCQ-OS (odds ratio (OR) = 1.73 (95% CI 1.05-2.85, P = 0.03)) and reduced weight (mean effect size, 0.72 kg (95% CI 0.01-1.42, P = 0.046)). There were no significant differences in other secondary endpoints. Adverse events were similar between dapagliflozin and placebo (44 (27.2%) versus 38 (23.5%) patients, respectively). These results indicate that 12 weeks of dapagliflozin treatment significantly improved patient-reported symptoms, physical limitations and exercise function and was well tolerated in chronic HFpEF.
Metrics
Details
- Title
- The SGLT2 inhibitor dapagliflozin in heart failure with preserved ejection fraction: a multicenter randomized trial
- Creators
- Michael E Nassif - Saint Luke's HospitalSheryl L Windsor - Saint Luke's HospitalBarry A Borlaug - Mayo Clinic in ArizonaDalane W Kitzman - Wake Forest UniversitySanjiv J Shah - Northwestern UniversityFengming Tang - Saint Luke's HospitalYevgeniy Khariton - University of Missouri–Kansas CityAli O Malik - University of Missouri–Kansas CityTaiyeb Khumri - Saint Luke's HospitalGuillermo Umpierrez - Emory UniversitySumant Lamba - First Coast Cardiovascular InstituteKavita Sharma - Johns Hopkins MedicineSadiya S Khan - Northwestern UniversityLokesh Chandra - Chicago Medical Research, Hazel Crest, IL, USARobert A Gordon - NorthShore University HealthSystemJohn J Ryan - University of UtahSunit-Preet Chaudhry - Saint Vincent Health SystemSusan M Joseph - University of Maryland, BaltimoreChen H Chow - Stormont Vail HealthManreet K Kanwar - Allegheny Health NetworkMichael Pursley - The Heart HouseElias S Siraj - Eastern Virginia Medical SchoolGregory D Lewis - Massachusetts General HospitalBarry S Clemson - OSF HealthCareMichael Fong - University of Southern CaliforniaMikhail N Kosiborod - The George Institute for Global Health
- Publication Details
- Nature medicine, v 27(11), pp 1954-1960
- Publisher
- Springer Nature
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiology
- Web of Science ID
- WOS:000712353600002
- Scopus ID
- 2-s2.0-85118104833
- Other Identifier
- 991021932105204721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
Highly Cited Paper
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Biochemistry & Molecular Biology
- Cell Biology
- Medicine, Research & Experimental