Effect of dapagliflozin on anaemia in DAPA-HF
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Effect of dapagliflozin on anaemia in DAPA-HF. / Docherty, Kieran F; Curtain, James P.; Anand, Inder S; Bengtsson, Olof; Inzucchi, Silvio E; Køber, Lars; Kosiborod, Mikhail N; Langkilde, Anna Maria; Martinez, Felipe A; Ponikowski, Piotr; Sabatine, Marc S; Schou, Morten; Sjöstrand, Mikaela; Solomon, Scott D; Jhund, Pardeep S; McMurray, John J V; DAPA-HF Investigators and Committees.
In: European Journal of Heart Failure, Vol. 23, No. 4, 2021, p. 617-628.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effect of dapagliflozin on anaemia in DAPA-HF
AU - Docherty, Kieran F
AU - Curtain, James P.
AU - Anand, Inder S
AU - Bengtsson, Olof
AU - Inzucchi, Silvio E
AU - Køber, Lars
AU - Kosiborod, Mikhail N
AU - Langkilde, Anna Maria
AU - Martinez, Felipe A
AU - Ponikowski, Piotr
AU - Sabatine, Marc S
AU - Schou, Morten
AU - Sjöstrand, Mikaela
AU - Solomon, Scott D
AU - Jhund, Pardeep S
AU - McMurray, John J V
AU - DAPA-HF Investigators and Committees
N1 - Publisher Copyright: © 2021 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Anaemia
KW - Clinical trials
KW - Heart failure with reduced ejection fraction
KW - Sodium–glucose co-transporter 2 inhibitor
U2 - 10.1002/ejhf.2132
DO - 10.1002/ejhf.2132
M3 - Journal article
C2 - 33615642
AN - SCOPUS:85103178139
VL - 23
SP - 617
EP - 628
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1567-4215
IS - 4
ER -
ID: 303038049