Physicians' Academy for Cardiovascular Education
SGLT2i improves symptoms in HF across the range of LVEF

SGLT2i improves symptoms in HF across the range of LVEF

News - May 23, 2022

DEFINE-HF and PRESERVED-HF: Dapagliflozin improves heart failure symptoms and physical limitations across the entire range of LVEF

Presented at ESC Heart Failure 2022 by Mikhail Kosiborod, MD (Kansas City, MO, USA)

Introduction and methods

Improvement of symptoms and physical limitations is an important goal of treatment in patients with heart failure, regardless of their injection fraction. This pooled patient-level analysis of DEFINE-HF and PRESERVED-HF investigated the effect of dapagliflozin on these outcomes across the range of LVEF.

DEFINE-HF and PRESERVED-HF were both randomized, 12-week, double blind trials with dapagliflozin vs. placebo in patients with chronic HF, NYHA class ≥II and elevated NT-proBNP. DEFINE-HF included patients with EF ≤ 40% (n=263) and PRESERVED-HF included patients with EF ≥ 45% (n=324). In the pooled cohort (n=587), 43% were women, 33% African-American, 66% had a history of HF hospitalization and 37% had NYHA Class III-IV.

The primary endpoint was change in KCCQ Clinical Summary Score (CSS) at 12 weeks (adjusted for sex, baseline KCCQ, EF, AF, eGFR, and T2DM). The current analysis specifically explored whether the effects of dapagliflozin on health status were different across the range of LVEF. LVEF was assessed as a categorical variable (≤40%; >40% to <60%; ≥60%) and as a continuous variable.

Main results

Conclusion

This pooled patient-level analysis of DEFINE-HF and PRESERVED-HF showed that dapagliflozin vs. placebo improved symptoms and physical limitations across the entire range of LVEF.

Kosiborod stated: “Collectively, these results support the use of dapagliflozin in patients with HF regardless of ejection fraction”.

– Our coverage of ESC Heart Failure 2022 is based on the information provided during the congress –

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