In-hospital Start Of Dapagliflozin Shows No Significant Short-term Benefit In Heart Failure Patients

In-hospital initiation of dapagliflozin did not importantly trim nan short-term consequence of cardiovascular decease aliases worsening bosom nonaccomplishment (HF) successful patients admitted for HF, though affirmative effects were seen erstwhile combining proceedings data, according to late-breaking investigation presented successful a Hot Line convention coming astatine ESC Congress 2025.

Hospitalization for HF is nan starring cardiovascular logic for infirmary admission and is associated pinch a precocious consequence of decease and different adverse outcomes during admittance and successful nan weeks aft discharge.

Initiating and optimising disease-modifying HF therapies during hospitalisation whitethorn amended some short- and semipermanent outcomes; however, location are constricted information connected initiating sodium-glucose cotransporter-2 inhibitors (SGLT2is) successful patients hospitalized for HF. We designed nan proceedings to trial nan presumption that in-hospital initiation of nan SGLT2i, dapagliflozin, arsenic compared pinch placebo, could safely and efficaciously alteration nan early consequence of cardiovascular decease aliases worsening HF among patients hospitalized for HF."

Doctor David Berg, an Investigator successful nan TIMI Study Group astatine Brigham and Women's Hospital, Boston, USA, and Principal Investigator of nan DAPA ACT HF-TIMI 68 trial

The DAPA ACT HF-TIMI 68 proceedings was a double-blind, placebo-controlled randomized proceedings conducted astatine 210 sites successful USA, Canada, Poland, Hungary and nan Czech Republic. Eligible patients were ≥18 years of property and were presently hospitalised pinch a superior test of HF, including signs and symptoms of fluid overload. Patients were required to person elevated natriuretic peptide levels during nan scale hospitalisation. Patients were randomised 1:1 to dapagliflozin 10 mg regular aliases placebo astatine slightest 24 hours and nary later than 14 days aft infirmary admittance and arsenic early arsenic imaginable pursuing first stabilisation. The superior efficacy result was a composite of cardiovascular decease aliases worsening HF complete nan first 2 months.

A full of 2,401 patients were randomized. The median property was 69 years and 33.9% were women. The median clip from infirmary admittance to randomization was 3.6 days.

The superior result of cardiovascular decease aliases worsening HF occurred successful 10.9% of patients successful nan dapagliflozin group and 12.7% of patients successful nan placebo group (hazard ratio [HR] 0.86; 95% assurance interval [CI] 0.68 to 1.08; p=0.20).

Cardiovascular decease occurred successful 2.5% of patients pinch dapagliflozin and 3.1% pinch placebo (HR 0.78; 95% CI 0.48 to 1.27), while a worsening HF arena occurred successful 9.4% and 10.3% of patients, respectively (HR 0.91; 95% CI 0.71 to 1.18).

All-cause mortality occurred successful 3.0% of patients successful nan dapagliflozin group and 4.5% of patients successful nan placebo group (HR 0.66; 95% CI 0.43 to 1.00). Rates of symptomatic hypotension were 3.6% and 2.2%, respectively, and rates of worsening kidney usability were 5.9% and 4.7% pinch dapagliflozin and placebo, respectively.

A prespecified meta-analysis was conducted of DAPA ACT HF-TIMI 68 positive tests pinch 2 different SGLT2is (empagliflozin and sotagliflozin) assessing in-hospital initiation successful 3,527 patients hospitalized for HF.4,5 SGLT2is reduced nan early consequence of cardiovascular decease aliases worsening HF (HR 0.71; 95% CI 0.54 to 0.93; p=0.012) and all-cause mortality (HR 0.57; 95% CI 0.41 to 0.80; p=0.001).

Doctor Berg concluded: "In-hospital initiation of dapagliflozin did not importantly trim nan consequence of cardiovascular decease aliases worsening HF complete nan first 2 months successful DAPA ACT HF-TIMI 68. However, nan totality of proceedings information suggests that in-hospital initiation of an SGLT2i reduces nan early consequence of cardiovascular decease aliases worsening HF and all-cause mortality."