Comparison between early and late dapagliflozin administration for decompensated heart failure

Sodium-glucose cotransporter 2 inhibitors have demonstrated positive effects in heart failure (HF) patients. However, the effects of dapagliflozin in patients with decompensated HF remain unclear. This study aimed to compare the efficacy and safety of early and late dapagliflozin administration for decompensated HF. Data regarding dapagliflozin administration from 70 patients diagnosed with HF between December 2020 and November 2021 at a Japanese heart centre were analysed retrospectively. Propensity score matching was performed to compare the clinical outcomes of early and late dapagliflozin administration for decompensated HF. The primary end point was HF admission one year after dapagliflozin administration. The secondary end points were evaluated based on 24-hour urine volume, cardiac death, changes in ejection fraction (EF), blood pressure, glomerular filtration rate (GFR), haemoglobin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, and side effects within one year of treatment. Fifteen matched pairs of patients were analysed. Admission rate within one year was significantly lower in the early administration group than in the late administration group (0 vs. 20%, p=0.03). Secondary end points were not significantly different between the two groups. In conclusion, early dapagliflozin administration significantly reduced HF admission within one year of treatment, although no differences were observed in 24-hour urine volume, cardiac death, EF, GFR, haemoglobin and NT-proBNP levels, and side effects.