Effect of dapagliflozin on anaemia in DAPA-HF

Docherty, K. F. et al. (2021) Effect of dapagliflozin on anaemia in DAPA-HF. European Journal of Heart Failure, 23(4), pp. 617-628. (doi: 10.1002/ejhf.2132) (PMID:33615642)

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Abstract

Background: 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 and reduced ejection fraction (HFrEF) in DAPA‐HF. We also analyzed the effect of dapagliflozin on outcomes, according to anaemia status at baseline. Methods: 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.. Findings: 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 (HR 0.68 [95%CI 0.52‐0.88] versus 0.76 [0.65‐0.89]; P‐interaction=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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Docherty, Dr Kieran and Curtain, Dr James and Jhund, Dr Pardeep and McMurray, Professor John and Kober, Professor Lars
Authors: Docherty, K. F., Curtain, J. P., Anand, I. S., Bengtsson, O., Inzucchi, S. E., Køber, L., Kosiborod, M. N., Langkilde, A. M., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Sjöstrand, M., Solomon, S. D., Jhund, P. S., and McMurray, J. J.V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:European Journal of Heart Failure
Publisher:Wiley
ISSN:1388-9842
ISSN (Online):1879-0844
Published Online:22 February 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in European Journal of Heart Failure 23(4): 617-628
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303944BHF Centre of ExcellenceRhian TouyzBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science