Butt, J. et al. (2023) Dapagliflozin and physical and social activity limitations in heart failure with reduced ejection fraction. JACC: Heart Failure, 11(10), pp. 1411-1423. (doi: 10.1016/j.jchf.2023.04.016) (PMID:37318419)
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Abstract
Background: Heart failure (HF) is associated with impaired physical function and poor quality of life and affects health status more profoundly than many other chronic diseases. Objectives: The authors examined the effects of dapagliflozin on specific physical and social limitations as reported by patients in the DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) trial. Methods: The effect of dapagliflozin on the change from baseline to 8 months in each of the individual physical and social activity limitation questions answered by patients completing the Kansas City Cardiomyopathy Questionnaire (KCCQ), and overall scores, were examined with mixed-effects models and responder analyses. Results: In total, 4,269 (90.0%) and 3,955 (83.4%) patients had complete data for both the physical and social activity limitation scores at baseline and 8 months, respectively. Compared with placebo, dapagliflozin significantly increased (improved) the mean KCCQ physical and social activity limitation scores at 8 months (placebo-corrected mean difference 1.94 [95% CI: 0.73-3.16] and 1.84 [95% CI: 0.43-3.25], respectively). Dapagliflozin also increased each of the individual components that comprise the physical and social activity limitations domains at 8 months, with the largest improvement seen in “hobbies or recreational activities” (placebo-corrected mean difference: 2.76 [95% CI: 1.06-4.46]) and “doing yardwork, housework, or carrying groceries” (placebo-corrected mean difference: 2.59 [95% CI: 0.76-4.42]). The proportion of patients with a 5-point improvement from baseline to 8 months in the KCCQ physical and social activity limitation scores was greater with dapagliflozin than with placebo (ORs: 1.23 [95% CI: 1.09-1.40] and 1.19 [95% CI: 1.05-1.35], respectively). Conclusions: In patients with HFrEF, dapagliflozin, compared with placebo, improved physical and social activity limitations as measured by KCCQ. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients with Chronic Heart Failure [DAPA-HF]; NCT03036124).
| Item Type: | Articles |
|---|---|
| Additional Information: | Drs McMurray and Jhund were supported by British Heart Foundation Centre of Research Excellence Grant RE/18/6/34217. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Butt, Mr Jawad and Docherty, Dr Kieran and Jhund, Professor Pardeep and McMurray, Professor John and Kober, Professor Lars |
| Authors: | Butt, J., Docherty, K. F., Kosiborod, M. N., Inzucchi, S. E., Køber, L., Langkilde, A. M., Martinez, F. A., Bengtsson, O., Ponikowski, P., Sabatine, M. S., Sjöstrand, M., Solomon, S., Jhund, P. S., and McMurray, J. J.V. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | JACC: Heart Failure |
| Publisher: | Elsevier |
| ISSN: | 2213-1779 |
| ISSN (Online): | 2213-1787 |
| Published Online: | 14 June 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in JACC: Heart Failure 11(10):1411-1423 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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