Eligibility for dapagliflozin and empagliflozin in a real-world heart failure population

Thorvaldsen, T., Ferrannini, G., Mellbin, L., Benson, L., Cosentino, F., McMurray, J. J.V. , Dahlström, U., Lund, L. H. and Savarese, G. (2022) Eligibility for dapagliflozin and empagliflozin in a real-world heart failure population. Journal of Cardiac Failure, 28(7), pp. 1050-1062. (doi: 10.1016/j.cardfail.2022.04.011) (PMID:35550428)

Abstract

Background: We investigated eligibility for dapagliflozin and empagliflozin in a real-world heart failure (HF) cohort based on selection criteria of DAPA-HF, DELIVER, and EMPEROR trials. Methods and Results: Selection criteria were applied to the Swedish HF registry out-patient population according to three scenarios: (i) a “trial scenario” applying all selection criteria; (ii) a “pragmatic scenario” applying the most clinically relevant criteria; (iii) a “label scenario” following the regulatory agencies labels. Of 49,317 patients, 55% had ejection fraction (EF)<40% and were assessed for eligibility based on DAPA-HF and EMPEROR-Reduced, 45% had EF≥40% and were assessed based on EMPEROR-Preserved and DELIVER. Eligibility using trial, pragmatic and label scenarios was: 35%, 61% and 80% for DAPA-HF; 31%, 55% and 81% for EMPEROR-Reduced; 30%, 61% and 74% for DELIVER; 32%, 59% and 75% for EMPEROR-Preserved. Main selection criteria limiting eligibility were HF duration and NT-proBNP. Eligible patients had more severe HF, more comorbidities, higher use of HF treatments and higher mortality/morbidity. Conclusions: In a real-world HF setting, eligibility for SGLT2i was similar whether selection criteria from DAPA-HF or EMPEROR-Reduced were applied in HFrEF, or EMPEROR-Preserved or DELIVER in HFpEF. These data might help stakeholders assessing the consequences of future trial eligibility.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McMurray, Professor John
• Authors: Thorvaldsen, T., Ferrannini, G., Mellbin, L., Benson, L., Cosentino, F., McMurray, J. J.V., Dahlström, U., Lund, L. H., and Savarese, G.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Journal of Cardiac Failure
• Publisher: Elsevier
• ISSN: 1071-9164
• ISSN (Online): 1532-8414
• Published Online: 10 May 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Journal of Cardiac Failure 28(7): 1050-1062
• Publisher Policy: Reproduced under a Creative Commons License