Projected effectiveness of dapagliflozin in heart failure with reduced ejection fraction in clinical practice

Area of Science:

• Cardiology
• Pharmacology
• Public Health

Background:

• Heart failure with reduced ejection fraction (HFrEF) remains a significant cause of mortality and hospitalizations.
• Sodium-glucose cotransporter 2 (SGLT2) inhibitors, like dapagliflozin, have shown efficacy in HFrEF, but real-world effectiveness data are crucial.

Purpose of the Study:

• To project the effectiveness of dapagliflozin in HFrEF patients within Spanish clinical practice.
• To estimate the impact of dapagliflozin on mortality and heart failure readmissions.

Main Methods:

• A multicenter cohort study in Spain included patients hospitalized for heart failure.
• Projected benefits were estimated using data from the DAPA-HF trial for eligible patients.
• Analysis focused on mortality and HF rehospitalization rates within one year post-discharge.

Main Results:

• 1199 out of 1595 enrolled patients were eligible for dapagliflozin.
• Without dapagliflozin, 1-year post-discharge rates were 20.5% mortality and 21.6% HF rehospitalization.
• Full dapagliflozin implementation projected a 3.5% absolute mortality reduction (NNT=28) and 6.5% HF readmission reduction (NNT=15).

Conclusions:

• Dapagliflozin treatment in clinical practice can substantially decrease mortality and heart failure readmissions.
• The findings support the widespread implementation of dapagliflozin for eligible HFrEF patients in Spain.
• Real-world data indicate dapagliflozin's significant role in managing HFrEF and improving patient outcomes.