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Short Communication

Projected clinical benefits of dapagliflozin in patients with heart failure with preserved ejection fraction

    Manuel Montero-Pérez-Barquero

    *Author for correspondence:

    E-mail Address: montero.manolo@gmail.com

    Internal Medicine, IMIBIC, University Hospital Reina Sofía, 14004, Córdoba, Spain

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    ,
    Carlos Escobar-Cervantes

    Servicio de Cardiología, Hospital la Paz de Madrid, 28046, Madrid, Spain

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    ,
    Pau Llàcer

    Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, IRYCIS, 28034, Madrid, Spain

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    ,
    Raúl Quirós-López

    Servicio de Medicina Interna, Hospital de la Costa del Sol, Marbella, 29603, Málaga, Spain

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    ,
    Joan C Trullás

    Internal Medicine Department, Hospital d’Olot, Tissue Repair & Regeneration Laboratory (TR2Lab), Universitat Central de Catalunya, Vic, 17800, Barcelona, Spain

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    ,
    Jose M Cerqueiro

    Servicio de Medicina Interna, Hospital Universitario Lucus Augusti, 27003, Lugo, Spain

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    ,
    Francisco Epelde-Gonzálo

    USU, Hospital Universitari Parc Taulí, 08208, Barcelona, Spain

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    ,
    Margarita Carrera-Izquierdo

    Servicio de Medicina Interna, Complejo Hospitalario de Soria, 42005, Soria, Spain

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    ,
    Francesc Formiga

    Internal Medicine Department, Hospital Universitari de Bellvitge, 08907, Barcelona, Spain

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    ,
    Alvaro González-Franco

    Servicio de Medicina Interna, Hospital Universitario Central de Asturias, 33011, Oviedo, Spain

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    &
    Jesús Casado-Cerrada

    Internal Medicine Department, University Hospital of Getafe, 28905, Madrid, Spain

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    Published Online:29 Jun 2023https://doi.org/10.2217/fca-2023-0015

    Abstract

    Aims: To address the projected clinical benefits of dapagliflozin among patients with heart failure (HF) with mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF). Methods: A multicenter, prospective, cohort study of patients ≥50 years admitted with HF to Spanish internal medicine departments. The projected clinical benefits of dapagliflozin were calculated from the DELIVER trial. Results: A total of 4049 patients were included; 3271 (80.8%) were eligible for dapagliflozin treatment, according to DELIVER criteria. Within 1 year after discharge, 22.2% were rehospitalized for HF and 21.6% died. Implementation of dapagliflozin would translate into an absolute risk reduction of 1.3% for mortality and 5.1% for HF readmission. Conclusion: HF patients with preserved or mildly reduced ejection fraction have a high risk of events. The use of dapagliflozin could substantially reduce the HF burden.

    Plain language summary

    Heart failure (HF) with preserved ejection fraction is frequent in clinical practice, particularly in the elderly. In HF with preserved ejection fraction, the heart still pumps a similar proportion of blood, but the heart muscle has become thicker. This means there is less space inside the heart to fill with blood, so too little is pumped out each time. Until very recently, no drugs had been shown to provide significant benefits on the outcome of the condition or the chance of recovery for these patients. Fortunately, recent clinical trials have demonstrated that treatment with drugs called SGLT2 inhibitors (e.g., dapagliflozin) could reduce the chance of being admitted to hospital or dying from HF. We investigated the benefits for patients who took dapagliflozin after being admitted to hospital and had HF with mildly reduced or preserved ejection fraction. We saw substantial benefits in this population.

    Tweetable abstract

    The implementation of dapagliflozin could substantially reduce heart failure burden among patients with with mildly reduced or preserved ejection fraction.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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