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Effects of Dapagliflozin in Asian Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF

BACKGROUND: Patients with heart failure with reduced ejection fraction (HFrEF) in Asia exhibit many differences from those in other parts of the world. OBJECTIVES: This study sought to investigate the efficacy and safety of dapagliflozin, compared with placebo, in HFrEF patients in Asia, compared wi...

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Autores principales: Docherty, Kieran F., Anand, Inder S., Chiang, Chern-En, Chopra, Vijay K., Desai, Akshay S., Kitakaze, Masafumi, Verma, Subodh, Vinh, Pham N., Inzucchi, Silvio E., Køber, Lars, Kosiborod, Mikhail N., Martinez, Felipe A., Bengtsson, Olof, Ponikowski, Piotr, Sabatine, Marc S., Sjöstrand, Mikaela, Solomon, Scott D., Langkilde, Anna Maria, Jhund, Pardeep S., McMurray, John J.V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9627879/
https://www.ncbi.nlm.nih.gov/pubmed/36339117
http://dx.doi.org/10.1016/j.jacasi.2022.02.004
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author Docherty, Kieran F.
Anand, Inder S.
Chiang, Chern-En
Chopra, Vijay K.
Desai, Akshay S.
Kitakaze, Masafumi
Verma, Subodh
Vinh, Pham N.
Inzucchi, Silvio E.
Køber, Lars
Kosiborod, Mikhail N.
Martinez, Felipe A.
Bengtsson, Olof
Ponikowski, Piotr
Sabatine, Marc S.
Sjöstrand, Mikaela
Solomon, Scott D.
Langkilde, Anna Maria
Jhund, Pardeep S.
McMurray, John J.V.
author_facet Docherty, Kieran F.
Anand, Inder S.
Chiang, Chern-En
Chopra, Vijay K.
Desai, Akshay S.
Kitakaze, Masafumi
Verma, Subodh
Vinh, Pham N.
Inzucchi, Silvio E.
Køber, Lars
Kosiborod, Mikhail N.
Martinez, Felipe A.
Bengtsson, Olof
Ponikowski, Piotr
Sabatine, Marc S.
Sjöstrand, Mikaela
Solomon, Scott D.
Langkilde, Anna Maria
Jhund, Pardeep S.
McMurray, John J.V.
author_sort Docherty, Kieran F.
collection PubMed
description BACKGROUND: Patients with heart failure with reduced ejection fraction (HFrEF) in Asia exhibit many differences from those in other parts of the world. OBJECTIVES: This study sought to investigate the efficacy and safety of dapagliflozin, compared with placebo, in HFrEF patients in Asia, compared with those elsewhere, enrolled in the DAPA-HF (Dapagliflozin and Prevention of Adverse-outcomes in Heart Failure) trial. METHODS: Patients in New York Heart Association functional class II to IV with a left ventricular ejection fraction ≤40% and elevated N-terminal pro–B-type natriuretic peptide were eligible for the DAPA-HF trial. The primary outcome in the DAPA-HF trial was the composite of an episode of worsening HF (HF hospitalization or urgent HF visit requiring intravenous therapy) or cardiovascular death. RESULTS: Of the 4,744 patients in the DAPA-HF trial, 1,096 (23.1%) were enrolled in Asia; 721 (15.2% overall, 65.8% of patients in Asia) were enrolled in East Asia (237 in China, 343 in Japan, and 141 in Taiwan), 138 (2.9% overall, 12.6% in Asia) in South-East Asia (Vietnam), and 237 (5.0% overall, 21.6% in Asia) in South Asia (India). Patients from Asia had similar rates of worsening HF events and mortality compared with patients elsewhere. Compared with placebo, dapagliflozin reduced the risk of the primary endpoint to the same extent in patients from Asia (HR: 0.65; 95% CI: 0.49 to 0.87) as elsewhere (HR: 0.77; 95% CI: 0.66 to 0.89) (P for interaction = 0.32). Consistent benefits were observed for the other prespecified outcomes and among the regions of Asia. Study drug discontinuation and prespecified adverse events did not differ between regions. CONCLUSIONS: Dapagliflozin, compared with placebo, reduced the risk of worsening HF events and cardiovascular death to the same extent in Asian patients as elsewhere. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients With Chronic Heart Failure [DAPA-HF]; NCT03036124)
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spelling pubmed-96278792022-11-04 Effects of Dapagliflozin in Asian Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF Docherty, Kieran F. Anand, Inder S. Chiang, Chern-En Chopra, Vijay K. Desai, Akshay S. Kitakaze, Masafumi Verma, Subodh Vinh, Pham N. Inzucchi, Silvio E. Køber, Lars Kosiborod, Mikhail N. Martinez, Felipe A. Bengtsson, Olof Ponikowski, Piotr Sabatine, Marc S. Sjöstrand, Mikaela Solomon, Scott D. Langkilde, Anna Maria Jhund, Pardeep S. McMurray, John J.V. JACC Asia Original Research BACKGROUND: Patients with heart failure with reduced ejection fraction (HFrEF) in Asia exhibit many differences from those in other parts of the world. OBJECTIVES: This study sought to investigate the efficacy and safety of dapagliflozin, compared with placebo, in HFrEF patients in Asia, compared with those elsewhere, enrolled in the DAPA-HF (Dapagliflozin and Prevention of Adverse-outcomes in Heart Failure) trial. METHODS: Patients in New York Heart Association functional class II to IV with a left ventricular ejection fraction ≤40% and elevated N-terminal pro–B-type natriuretic peptide were eligible for the DAPA-HF trial. The primary outcome in the DAPA-HF trial was the composite of an episode of worsening HF (HF hospitalization or urgent HF visit requiring intravenous therapy) or cardiovascular death. RESULTS: Of the 4,744 patients in the DAPA-HF trial, 1,096 (23.1%) were enrolled in Asia; 721 (15.2% overall, 65.8% of patients in Asia) were enrolled in East Asia (237 in China, 343 in Japan, and 141 in Taiwan), 138 (2.9% overall, 12.6% in Asia) in South-East Asia (Vietnam), and 237 (5.0% overall, 21.6% in Asia) in South Asia (India). Patients from Asia had similar rates of worsening HF events and mortality compared with patients elsewhere. Compared with placebo, dapagliflozin reduced the risk of the primary endpoint to the same extent in patients from Asia (HR: 0.65; 95% CI: 0.49 to 0.87) as elsewhere (HR: 0.77; 95% CI: 0.66 to 0.89) (P for interaction = 0.32). Consistent benefits were observed for the other prespecified outcomes and among the regions of Asia. Study drug discontinuation and prespecified adverse events did not differ between regions. CONCLUSIONS: Dapagliflozin, compared with placebo, reduced the risk of worsening HF events and cardiovascular death to the same extent in Asian patients as elsewhere. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients With Chronic Heart Failure [DAPA-HF]; NCT03036124) Elsevier 2022-03-29 /pmc/articles/PMC9627879/ /pubmed/36339117 http://dx.doi.org/10.1016/j.jacasi.2022.02.004 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Docherty, Kieran F.
Anand, Inder S.
Chiang, Chern-En
Chopra, Vijay K.
Desai, Akshay S.
Kitakaze, Masafumi
Verma, Subodh
Vinh, Pham N.
Inzucchi, Silvio E.
Køber, Lars
Kosiborod, Mikhail N.
Martinez, Felipe A.
Bengtsson, Olof
Ponikowski, Piotr
Sabatine, Marc S.
Sjöstrand, Mikaela
Solomon, Scott D.
Langkilde, Anna Maria
Jhund, Pardeep S.
McMurray, John J.V.
Effects of Dapagliflozin in Asian Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF
title Effects of Dapagliflozin in Asian Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF
title_full Effects of Dapagliflozin in Asian Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF
title_fullStr Effects of Dapagliflozin in Asian Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF
title_full_unstemmed Effects of Dapagliflozin in Asian Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF
title_short Effects of Dapagliflozin in Asian Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF
title_sort effects of dapagliflozin in asian patients with heart failure and reduced ejection fraction in dapa-hf
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9627879/
https://www.ncbi.nlm.nih.gov/pubmed/36339117
http://dx.doi.org/10.1016/j.jacasi.2022.02.004
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