Effects of dapagliflozin on heart failure hospitalizations according to severity of inpatient course: Insights from DELIVER and DAPA‐HF

• DOI: 10.1002/ejhf.2912
• Publication Date: 2023-05-21T07:00:27Z
• Authors: Safia Chatur; Toru Kondo; Brian L. Claggett; Kieran Docherty; Zi Michael Miao; Akshay S. Desai; Pardeep S. Jhund; Rudolf A. de Boer; Adrian F. Hernandez; Silvio E. Inzucchi; Mikhail N. Kosiborod; Carolyn S.P. Lam; Felipe A. Martinez; Sanjiv J. Shah; Magnus Petersson; Anna Maria Langkilde; John J.V. McMurray; Scott D. Solomon; Muthiah Vaduganathan
• Keywords: Dapagliflozin

Dapagliflozin resulted in significant and sustained reductions first recurrent heart failure (HF) hospitalizations among patients with HF across the spectrum of ejection fraction. How treatment dapagliflozin differentially impacts hospitalization for varying complexity is not well studied.In DELIVER DAPA-HF trials, we examined effects on adjudicated hospital length stay (LOS). requiring intensive care unit stay, intravenous vasoactive therapies, invasive/non-invasive ventilation, mechanical fluid removal or circulatory support were categorized as complicated. The balance was classified uncomplicated. Of total 1209 reported DELIVER, 854 (71%) uncomplicated 355 (29%) 799 DAPA-HF, 453 (57%) 346 (43%) Relative to experiencing a hospitalization, those complicated had significantly higher in-hospital mortality both (16.7% vs. 2.3%, p < 0.001) (15.1% 3.8%, 0.001). similarly reduced 'uncomplicated' (DELIVER: rate ratio [RR] 0.67, 95% confidence interval [CI] 0.55-0.82 DAPA-HF: RR 0.69, CI 0.54-0.87) 'complicated' 0.82, 0.63-1.06 0.75, 0.58-0.97). consistently irrespective their LOS: <5 days 0.76, 0.58-0.99 0.58, 0.42-0.80) ≥5 0.71, 0.58-0.86 0.77, 0.62-0.94).A substantial proportion (∼30-40%) fraction required intensification beyond standard diuretics. Such experienced mortality. Treatment regardless severity inpatient course LOS.ClinicalTrials.gov, (NCT03619213) (NCT03036124).