DAPA-HF applicability: the point of view of a cardiology setting

Area of Science:

• Cardiology
• Pharmacology

Background:

• Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) demonstrate efficacy in reducing heart failure (HF) hospitalizations, chronic kidney disease (CKD) progression, and mortality.
• Real-world data is crucial for understanding treatment generalizability beyond clinical trial populations.

Purpose of the Study:

• To evaluate the eligibility of patients with heart failure with reduced ejection fraction (HFrEF) in the Italian Network on Heart Failure (IN-HF) registry for the DAPA-HF trial criteria.
• To assess the applicability of SGLT2 inhibitor findings to contemporary HFrEF patient cohorts.

Main Methods:

• Analysis of 3415 HFrEF patients from the IN-HF registry.
• Comparison of patient characteristics against the DAPA-HF trial population (4744 patients).
• Assessment of theoretical eligibility for DAPA-HF inclusion criteria.

Main Results:

• 3415 IN-HF patients had overlapping baseline characteristics with DAPA-HF participants.
• A theoretical eligibility rate of 73% for DAPA-HF criteria was observed in the IN-HF cohort.
• The IN-HF population showed a lower prevalence of type 2 diabetes and ischemic heart failure etiology compared to DAPA-HF.

Conclusions:

• A significant majority of contemporary HFrEF patients followed in cardiology settings meet eligibility criteria for trials like DAPA-HF.
• Findings suggest that the benefits of SGLT2 inhibitors observed in clinical trials are likely generalizable to a broader HFrEF population.
• This study provides valuable insights for clinicians and policymakers regarding SGLT2 inhibitor use in real-world HFrEF management.