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Effects of Dapagliflozin on Cardiovascular Events, Death, and Safety Outcomes in Patients with Heart Failure: A Meta-Analysis

American Journal of Cardiovascular Drugs volume 21, pages 321–330 (2021)Cite this article

Abstract

Background

Several clinical trials of dapagliflozin in patients with type 2 diabetes mellitus (T2DM) at elevated cardiovascular risk have observed reduced hospitalization for heart failure (HHF). Several studies have also suggested cardiovascular benefits for patients with HF regardless of whether or not they have T2DM.

Objective

This meta-analysis was conducted to evaluate the therapeutic effects of dapagliflozin in patients with HF.

Methods

The PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched from database inception to 15 February 2020. Clinical studies of dapagliflozin use in patients with HF were included. Data on HHF, all-cause mortality, cardiovascular death, major adverse cardiovascular events (MACE), systolic blood pressure, body weight, glycated hemoglobin (HbA1c), and adverse events were collected for analysis.

Results

Four randomized controlled trials involving 6738 patients with HF were included in this meta-analysis. Patients receiving dapagliflozin showed a significantly lower incidence of HHF [risk ratio (RR) 0.72; P < 0.00001], all-cause mortality (RR 0.83; P = 0.004), cardiovascular death (RR 0.86; P = 0.03), and MACE (RR 0.88; P = 0.03). Moreover, patients receiving dapagliflozin also showed significant improvements in systolic blood pressure and body weight. However, no statistical difference was observed in HbA1c. In addition, hypoglycemia, volume depletion, and renal impairment was not more frequent with dapagliflozin than with placebo.

Conclusion

This meta-analysis suggests that dapagliflozin could be a therapeutic strategy for patients with HF regardless of the presence or absence of T2DM.

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Author notes

  1. Xiao-Dong Zheng, Qiang Qu and Xing-Yu Jiang contributed equally to this work.

Authors and Affiliations

  1. Department of Intensive Care Unit, Suqian First Hospital, Suqian Clinical College of Xuzhou Medical University, Affiliated Hospital of Kangda College of Nanjing Medical University, Suqian, China

    Xiao-Dong Zheng & Cheng Tang

  2. Department of Critical Care, Suqian Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Suqian, Jiangsu, China

    Xiao-Dong Zheng & Cheng Tang

  3. The First Clinical Medical College of Nanjing Medical University, Nanjing, China

    Qiang Qu, Xing-Yu Jiang, Zhong-Yuan Wang, Cheng Tang & Jin-Yu Sun

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Xiao-Dong Zheng, Qiang Qu, Xing-Yu Jiang, Zhong-Yuan Wang, Cheng Tang, and Jin-Yu Sun have no potential conflicts of interest that might be relevant to the contents of this manuscript.

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Cite this article

Zheng, XD., Qu, Q., Jiang, XY. et al. Effects of Dapagliflozin on Cardiovascular Events, Death, and Safety Outcomes in Patients with Heart Failure: A Meta-Analysis. Am J Cardiovasc Drugs 21, 321–330 (2021). https://doi.org/10.1007/s40256-020-00441-x

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