Butt, J. H. et al. (2024) Heart failure, investigator-reported sleep apnea and dapagliflozin: A patient-level pooled meta-analysis of DAPA-HF and DELIVER. Journal of Cardiac Failure, 30(3), pp. 436-448. (doi: 10.1016/j.cardfail.2023.08.027) (PMID:38104937)
![[img]](https://eprints.gla.ac.uk/style/images/fileicons/text.png) |
Text
312830.pdf - Published Version Available under License Creative Commons Attribution. 1MB |
Abstract
Background: Sleep apnea is more common in patients with heart failure (HF) than in the general population, but little is known about its association with clinical outcomes in different HF phenotypes or how it might modify the effect of HF therapy. Objectives: To examine the prevalence of sleep apnea, its association with outcomes, and the effects of dapagliflozin in HF patients with and without sleep apnea in a pooled analysis of two trials comparing dapagliflozin to placebo in HFrEF (DAPA-HF) and HFmrEF/HFpEF (DELIVER). Methods: A history of sleep apnea was investigator-reported. The primary outcome was a composite of worsening HF or cardiovascular death. Results: The prevalence of sleep apnea was 5.7% and 7.8% in patients with HFrEF and HFmrEF/HFpEF, respectively. The primary outcome occurred at a rate of 16.0 in participants with sleep apnea compared to 10.6 per 100 person-years in those without (adjusted HR 1.29 [95%CI, 1.10-1.52]). Compared with placebo, dapagliflozin reduced the risk of the primary endpoint to the same extent in patients with (HR 0.78 [95% CI, 0.59-1.03]) and without sleep apnea (HR 0.79 [0.72-0.87]) [Pinteraction=0.93]. The beneficial effects of dapagliflozin on other clinical outcomes and symptom burden, physical function, and quality of life were consistent in participants with and without sleep apnea. Conclusions: In DAPA-HF and DELIVER, the true prevalence of sleep apnea was likely underestimated.An investigator-reported history of sleep apnea was associated with higher rates of worsening HF events. The benefits of dapagliflozin on clinical outcomes were consistent in patients with and without sleep apnea.
| Item Type: | Articles |
|---|---|
| Additional Information: | Funding: The DAPA-HF and DELIVER trials were funded by AstraZeneca. Drs. McMurray and Jhund are supported by a 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 Jhund, Professor Pardeep and McMurray, Professor John and Kober, Professor Lars |
| Authors: | Butt, J. H., Jering, K., de Boer, R. A., Claggett, B. L., Desai, A. S., Hernandez, A. F., Inzucchi, S. E., Jhund, P. S., Køber, L., Kosiborod, M. N., Lam, C. S.P., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Shah, S. J., Vaduganathan, M., Langkilde, A. M., Bengtsson, O., Petersson, M., Sjöstrand, M., and McMurray, J. J.V. |
| 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: | 15 December 2023 |
| Copyright Holders: | Copyright © 2023 The Author(s). |
| First Published: | First published in Journal of Cardiac Failure 30(3):436-448 |
| Publisher Policy: | Reproduced under a Creative Commons license |
University Staff: Request a correction | Enlighten Editors: Update this record
Funder and Project Information
Funder and Project Information