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Dapagliflozin in Heart Failure: A Comprehensive Meta-analysis on Functional Capacity, Symptoms, and Safety Outcomes
Basilio Addo1, Walter Agyeman2, Sammudeen Ibrahim2
1Department of Internal Medicine, Piedmont Athens Regional Medical Center, 1199 Prince Avenue, Athens, GA, 30606, USA. basilioaddo@yahoo.com.
Summary
Dapagliflozin significantly improved heart failure patient quality of life (KCCQ scores) and reduced hospitalizations. While not statistically significant, functional capacity (6-min walk distance) showed a positive trend, with a mortality benefit observed in reduced ejection fraction patients.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Heart failure (HF) remains a leading cause of hospitalization and mortality globally.
- Existing HF therapies have limitations, necessitating novel treatment strategies.
- Dapagliflozin, an SGLT2 inhibitor, shows promise in managing HF, but its effects on functional capacity and safety require detailed evaluation across HF subtypes.
Purpose of the Study:
- To compare the effects of dapagliflozin versus placebo in heart failure patients.
- To assess the impact of dapagliflozin on functional capacity, symptoms, and safety outcomes.
- To investigate dapagliflozin's efficacy in heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF) populations.
Main Methods:
- A systematic meta-analysis of randomized controlled trials (RCTs) was conducted.
- Searches were performed across major databases: PubMed, Web of Science, Cochrane Library, and Scopus.
- Primary outcomes included changes in 6-minute walk distance (6MWD) and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, alongside safety measures like hospitalization, mortality, and adverse events.
Main Results:
- Dapagliflozin significantly improved KCCQ scores (RR 2.75, p < 0.00001) but did not significantly alter 6MWD (RR 3.59, p = 0.16).
- A significant reduction in heart failure hospitalizations (RR 0.76, p < 0.00001) and all-cause mortality (RR 0.90, p = 0.03) was observed.
- No significant difference in adverse events was noted between dapagliflozin and placebo groups (RR 0.96, p = 0.39).
Conclusions:
- Dapagliflozin significantly enhances quality of life (KCCQ scores) in both HFrEF and HFpEF patients.
- The drug demonstrates a significant benefit in reducing heart failure hospitalizations across all patient classes.
- While functional capacity (6MWD) did not reach statistical significance, a trend favoring dapagliflozin was observed, alongside a mortality benefit in HFrEF patients.
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