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Return to: Twitter Facebook Linkedin Reddit Get Citation Citation Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy. AMA Citation Hinohara T, Mechanick JI. Hinohara T, & Mechanick J.I. Hinohara, Tomoya, and Jeffrey I. Mechanick. Critical Analysis of DAPA-HF: the Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial. Hurst's the Heart Updates, 16 October 2019. McGraw-Hill, 2019. AccessCardiology. https://accesscardiology.mhmedical.com/updatesContent.aspx?gbosid=506581§ionid=229608389APA Citation Hinohara T, Mechanick JI. Hinohara T, & Mechanick J.I. Hinohara, Tomoya, and Jeffrey I. Mechanick. (2019). Critical analysis of dapa-hf: the dapagliflozin and prevention of adverse-outcomes in heart failure trial. Fuster V. Fuster V Fuster, Valentin. Hurst's the heart updates. McGraw-Hill. https://accesscardiology.mhmedical.com/updatesContent.aspx?gbosid=506581§ionid=229608389.MLA Citation Hinohara T, Mechanick JI. Hinohara T, & Mechanick J.I. Hinohara, Tomoya, and Jeffrey I. Mechanick. "Critical Analysis of DAPA-HF: the Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial." Hurst's the Heart Updates Fuster V. Fuster V Fuster, Valentin. McGraw-Hill, 2019, https://accesscardiology.mhmedical.com/updatesContent.aspx?gbosid=506581§ionid=229608389. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Tools Clip Full Chapter Figures Only Tables Only Videos Only Supplementary Content Top Critical Analysis of DAPA-HF: the Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial by Tomoya Hinohara, Jeffrey I. Mechanick Listen + +Update to Chapter 28: diabetes and Cardiovascular Disease, and Chapter 70: The Diagnosis and Management of Chronic Heart Failure Study Summary + +The DAPA-HF trial evaluated the efficacy of the SGLT2 inhibitor dapagliflozin in reducing cardiac outcomes in patients with HFrEF (LVEF £40%) irrespective of diabetes status. Patients were randomly assigned to receive 10 mg of dapagliflozin (n = 2,373) or placebo (n = 2,371) daily. During follow-up (median 18.2 months), the incidence of the primary composite outcome of first episode of worsening HF ( hospitalization or an urgent care HF visit) or cardiovascular death was 26% lower in the dapagliflozin group than in the placebo group (HR 0.74; P <0.00001). The primary outcome results were similar when stratified by diabetes status. There was a 30% reduction in the occurrence of worsening HF (HR 0.70; P <0.00004), and an 18% reduction in cardiovascular death (HR 0.82; P <0.028) with dapagliflozin compared with placebo. Rates of adverse events — including volume depletion, renal dysfunction, major hypoglycemia, and lower limb amputation — were similar between the groups. Commentary + +Study Strengths: DAPA-HF is the first trial in which the efficacy of an SGLT2 inhibitor in reducing cardiac outcomes has been evaluated in patients with HFrEF regardless of diabetes status. Previous studies demonstrating a reduction in HF-related hospitalizations with SGLT2 inhibitors only included patients with type 2 diabetes and most did not have HF. +Study Limitations: No comments can be made as the manuscript has not yet been published. +Next Steps/Clinical Perspective: The DAPA-HF trial is a landmark study. If the results are corroborated, dapagliflozin may be considered an effective medication for the secondary prevention of HFrEF, rather than solely as a treatment for diabetes. The benefits of dapagliflozin were seen in patients who were already taking guideline-recommended medications for HF. This study identifies a new mechanistic approach in the treatment of HFrEF, and results from studies of HFpEF are awaited. Further research is needed to determine whether the findings represent a class effect for SGLT2 inhibitors and whether they are also effective for the primary prevention of HF. Trial Reference + + + +Presented by John McMurray at the European Society of Cardiology Congress, Paris, France, September 1 2019.