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Scientific article
English

Prognosis of patients eligible for dapagliflozin in acute heart failure

Published inEuropean journal of clinical investigation, vol. 50, no. 6, e13245
Publication date2020-06
Abstract

Background: Dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, was shown in the DAPA-HF study to reduce the risk of worsening heart failure or death in symptomatic patients with left ejection fraction <40%, irrespective of diabetes. The aim of this study was to evaluate eligibility status for dapagliflozin in non-selected patients hospitalized for acute decompensated heart failure (ADHF), as well as prognostic implications of this status.

Materials and methods: Analysis of 815 patients recruited in a prospective cohort of acute heart failure at the University Hospitals of Geneva, consisting of consecutive patients admitted with ADHF. Eligibility for dapagliflozin was determined using criteria described DAPA-HF.

Results: Of 815 patients, 220 (27%) were eligible for dapagliflozin treatment. In survival analysis, patients who were eligible for dapagliflozin had better clinical outcomes with respect to all-cause mortality and rehospitalization as compared to those who were not eligible. In multivariate analysis, the hazard ratio for all-cause mortality or readmission in patients eligible for dapagliflozin was 0.82 (95% CI 0.68-0.999, P = .049) as compared to the non-eligible.

Conclusions: Using DAPA-HF criteria, only 27% of non-selected patients admitted for ADHF are theoretically eligible for dapagliflozin. This eligibility for dapagliflozin is associated with better outcomes. Further evaluation of the benefits of dapagliflozin in selected HF patients may be of interest. This may have implications for selection criteria in future randomized effectiveness studies.

eng
Keywords
  • Acute heart failure
  • Dapagliflozin
  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Benzhydryl Compounds / therapeutic use
  • Cause of Death
  • Cohort Studies
  • Eligibility Determination
  • Female
  • Glucosides / therapeutic use
  • Heart Failure / metabolism
  • Heart Failure / physiopathology
  • Heart Failure / therapy
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • Multivariate Analysis
  • Patient Readmission / statistics & numerical data
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use
  • Stroke Volume
Citation (ISO format)
CARBALLO, Juan Sebastian et al. Prognosis of patients eligible for dapagliflozin in acute heart failure. In: European journal of clinical investigation, 2020, vol. 50, n° 6, p. e13245. doi: 10.1111/eci.13245
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Article (Published version)
Identifiers
ISSN of the journal0014-2972
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Creation04/06/2022 8:28:00 AM
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