Kieran F Docherty1, James P Curtain1, Inder S Anand2, Olof Bengtsson3, Silvio E Inzucchi4, Lars Køber5, Mikhail N Kosiborod6,7, Anna Maria Langkilde3, Felipe A Martinez8, Piotr Ponikowski9, Marc S Sabatine10, Morten Schou11, Mikaela Sjöstrand3, Scott D Solomon12, Pardeep S Jhund1, John J V McMurray1. 1. BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. 2. Department of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA. 3. AstraZeneca R&D, Gothenburg, Sweden. 4. Section of Endocrinology, Yale University School of Medicine, New Haven, CT, USA. 5. Rigshospitalet Copenhagen, University Hospital, Copenhagen, Denmark. 6. Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO, USA. 7. The George Institute for Global Health, University of New South Wales, Sydney, Australia. 8. National University of Cordoba, Cordoba, Argentina. 9. Wroclaw Medical University, Wroclaw, Poland. 10. TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA. 11. Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark. 12. Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Abstract
AIM: Anaemia is common in heart failure and associated with worse outcomes. We examined the effect of dapagliflozin on correction of anaemia in patients with heart failure (HF) and reduced ejection fraction in DAPA-HF. We also analysed the effect of dapagliflozin on outcomes, according to anaemia status at baseline. METHODS AND RESULTS:Anaemia was defined at baseline as a haematocrit <39% in men and <36% in women. Resolution of anaemia was defined as two consecutive haematocrit measurements above these thresholds at any time during follow-up. The primary outcome was a composite of worsening HF (hospitalization or urgent visit requiring intravenous therapy) or cardiovascular death. Of the 4744 patients randomized in DAPA-HF, 4691 had a haematocrit available at baseline, of which 1032 were anaemic (22.0%). The rate of the primary outcome was higher in patients with anaemia (16.1 per 100 person-years) compared with those without (12.9 per 100 person-years). Anaemia was corrected in 62.2% of patients in the dapagliflozin group, compared with 41.1% of patients in the placebo group. The effect of dapagliflozin on the primary outcome was consistent in anaemic compared with non-anaemic patients [hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.52-0.88 vs. HR 0.76, 95% CI 0.65-0.89; interaction P = 0.44]. Similar findings were observed for cardiovascular death, HF hospitalization, and all-cause mortality. Patients with resolution of anaemia had better outcomes than those in which anaemia persisted. CONCLUSION: Patients with anaemia had worse outcomes in DAPA-HF. Dapagliflozin corrected anaemia more often than placebo and improved outcomes, irrespective of anaemia status at baseline.
RCT Entities:
AIM: Anaemia is common in heart failure and associated with worse outcomes. We examined the effect of dapagliflozin on correction of anaemia in patients with heart failure (HF) and reduced ejection fraction in DAPA-HF. We also analysed the effect of dapagliflozin on outcomes, according to anaemia status at baseline. METHODS AND RESULTS:Anaemia was defined at baseline as a haematocrit <39% in men and <36% in women. Resolution of anaemia was defined as two consecutive haematocrit measurements above these thresholds at any time during follow-up. The primary outcome was a composite of worsening HF (hospitalization or urgent visit requiring intravenous therapy) or cardiovascular death. Of the 4744 patients randomized in DAPA-HF, 4691 had a haematocrit available at baseline, of which 1032 were anaemic (22.0%). The rate of the primary outcome was higher in patients with anaemia (16.1 per 100 person-years) compared with those without (12.9 per 100 person-years). Anaemia was corrected in 62.2% of patients in the dapagliflozin group, compared with 41.1% of patients in the placebo group. The effect of dapagliflozin on the primary outcome was consistent in anaemic compared with non-anaemic patients [hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.52-0.88 vs. HR 0.76, 95% CI 0.65-0.89; interaction P = 0.44]. Similar findings were observed for cardiovascular death, HF hospitalization, and all-cause mortality. Patients with resolution of anaemia had better outcomes than those in which anaemia persisted. CONCLUSION:Patients with anaemia had worse outcomes in DAPA-HF. Dapagliflozin corrected anaemia more often than placebo and improved outcomes, irrespective of anaemia status at baseline.
Authors: Ahmed A Kolkailah; Stephen D Wiviott; Itamar Raz; Sabina A Murphy; Ofri Mosenzon; Deepak L Bhatt; Lawrence A Leiter; John P H Wilding; Ingrid Gause-Nilsson; Marc S Sabatine; Darren K McGuire Journal: Diabetes Care Date: 2022-02-01 Impact factor: 19.112
Authors: Kieran F Docherty; Paul Welsh; Subodh Verma; Rudolf A De Boer; Eileen O'Meara; Olof Bengtsson; Lars Køber; Mikhail N Kosiborod; Ann Hammarstedt; Anna Maria Langkilde; Daniel Lindholm; Dustin J Little; Mikaela Sjöstrand; Felipe A Martinez; Piotr Ponikowski; Marc S Sabatine; David A Morrow; Morten Schou; Scott D Solomon; Naveed Sattar; Pardeep S Jhund; John J V McMurray Journal: Circulation Date: 2022-08-16 Impact factor: 39.918
Authors: Petter Bjornstad; Peter J Greasley; David C Wheeler; Glenn M Chertow; Anna Maria Langkilde; Hiddo J L Heerspink; DaniëL H Van Raalte Journal: J Card Fail Date: 2021-07-18 Impact factor: 5.712