PMID- 36054231
OWN - NLM
STAT- MEDLINE
DCOM- 20221128
LR  - 20231202
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Print)
IS  - 1388-9842 (Linking)
VI  - 24
IP  - 10
DP  - 2022 Oct
TI  - Dapagliflozin and New York Heart Association functional class in heart failure 
      with mildly reduced or preserved ejection fraction: the DELIVER trial.
PG  - 1892-1901
LID - 10.1002/ejhf.2652 [doi]
AB  - AIMS: This pre-specified analysis of the DELIVER trial examined whether clinical 
      benefits of dapagliflozin in heart failure (HF) with left ventricular ejection 
      fraction (LVEF) >40% varied by baseline New York Heart Association (NYHA) class 
      and examined the treatment effects on NYHA class over time. METHODS AND RESULTS: 
      Treatment effects of dapagliflozin by baseline NYHA class II (n = 4713) versus 
      III/IV (n = 1549) were examined on the primary endpoint (cardiovascular death or 
      worsening HF event) and key secondary endpoints. Effects of dapagliflozin on 
      change in NYHA class at 4, 16, and 32 weeks were also evaluated. Higher baseline 
      NYHA class was associated with older age, female sex, greater comorbidity burden, 
      lower LVEF, and higher natriuretic peptide levels. Participants with baseline 
      NYHA class III/IV, as compared with II, were independently more likely to 
      experience the primary endpoint (adjusted hazard ratio [HR] 1.16 [95% confidence 
      interval, 1.02-1.33]) and all-cause death (adjusted HR 1.22 [1.06-1.40]). 
      Dapagliflozin consistently reduced the risk of the primary endpoint compared with 
      placebo, irrespective of baseline NYHA class (HR 0.81 [0.70-0.94] for NYHA class 
      II vs. HR 0.80 [0.65-0.98] for NYHA class III/IV; p(interaction)  = 0.921). 
      Participants with NYHA class III/IV had greater improvement in Kansas City 
      Cardiomyopathy Questionnaire total symptom scores between baseline and 32 weeks 
      (+4.8 [2.5-7.1]) versus NYHA class II (+1.8 [0.7-2.9]; p(interaction)  = 0.011). 
      Dapagliflozin was associated with higher odds of any improvement in NYHA class 
      (odds ratio [OR] 1.32 [1.16-1.51]), as well as improvement to NYHA class I (OR 
      1.43 [1.17-1.75]), versus placebo at 32 weeks, with benefits seen as early as 
      4 weeks. CONCLUSIONS: Among symptomatic patients with HF and LVEF >40%, treatment 
      with dapagliflozin provided clinical benefit irrespective of baseline NYHA class 
      and was associated with early and sustained improvements in NYHA class over time.
CI  - (c) 2022 The Authors. European Journal of Heart Failure published by John Wiley & 
      Sons Ltd on behalf of European Society of Cardiology.
FAU - Ostrominski, John W
AU  - Ostrominski JW
AUID- ORCID: 0000-0002-2866-9414
AD  - Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, MA, USA.
FAU - Vaduganathan, Muthiah
AU  - Vaduganathan M
AUID- ORCID: 0000-0003-0885-1953
AD  - Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, MA, USA.
FAU - Claggett, Brian L
AU  - Claggett BL
AD  - Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, MA, USA.
FAU - de Boer, Rudolf A
AU  - de Boer RA
AUID- ORCID: 0000-0002-4775-9140
AD  - Department of Cardiology, University Medical Center Groningen, University of 
      Groningen, Groningen, The Netherlands.
FAU - Desai, Akshay S
AU  - Desai AS
AUID- ORCID: 0000-0002-1443-0701
AD  - Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, MA, USA.
FAU - Dobreanu, Dan
AU  - Dobreanu D
AD  - University of Medicine, Pharmacy, Science and Technology "G.E. Palade", Targu 
      Mures, Romania.
FAU - Hernandez, Adrian F
AU  - Hernandez AF
AD  - Department of Medicine, Duke University, Durham, NC, USA.
AD  - Duke Clinical Research Institute, Duke University, Durham, NC, USA.
FAU - Inzucchi, Silvio E
AU  - Inzucchi SE
AD  - Section of Endocrinology, Yale University School of Medicine, New Haven, CT, USA.
FAU - Jhund, Pardeep S
AU  - Jhund PS
AUID- ORCID: 0000-0003-4306-5317
AD  - British Heart Foundation Cardiovascular Research Centre, University of Glasgow, 
      Glasgow, UK.
FAU - Kosiborod, Mikhail
AU  - Kosiborod M
AD  - St Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas 
      City, MI, USA.
FAU - Lam, Carolyn S P
AU  - Lam CSP
AD  - Department of Cardiology, University Medical Center Groningen, University of 
      Groningen, Groningen, The Netherlands.
AD  - National Heart Centre Singapore and Duke-National University of Singapore, 
      Singapore, Singapore.
FAU - Langkilde, Anna M
AU  - Langkilde AM
AD  - Late Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals 
      R&D, Gothenburg, Sweden.
FAU - Lindholm, Daniel
AU  - Lindholm D
AD  - Late Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals 
      R&D, Gothenburg, Sweden.
FAU - Martinez, Felipe A
AU  - Martinez FA
AD  - Universidad Nacional de Cordoba, Cordoba, Argentina.
FAU - O'Meara, Eileen
AU  - O'Meara E
AD  - Institut de Cardiologie de Montreal, Universite de Montreal, Montreal, Quebec, 
      Canada.
FAU - Petersson, Magnus
AU  - Petersson M
AD  - Late Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals 
      R&D, Gothenburg, Sweden.
FAU - Shah, Sanjiv J
AU  - Shah SJ
AUID- ORCID: 0000-0002-5655-8201
AD  - Feinberg Cardiovascular Research Institute, Northwestern University Feinberg 
      School of Medicine, Chicago, IL, USA.
FAU - Thierer, Jorge
AU  - Thierer J
AD  - Jefe de Unidad de Insuficiencia Cardiaca, Centro de Education Medica e 
      Investigaciones Clinicas Norberto Quirno (CEMIC), Buenos Aires, Argentina.
FAU - McMurray, John J V
AU  - McMurray JJV
AUID- ORCID: 0000-0002-6317-3975
AD  - British Heart Foundation Cardiovascular Research Centre, University of Glasgow, 
      Glasgow, UK.
FAU - Solomon, Scott D
AU  - Solomon SD
AD  - Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, MA, USA.
LA  - eng
GR  - P30 DK045735/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220827
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 1ULL0QJ8UC (dapagliflozin)
SB  - IM
CIN - Eur J Heart Fail. 2022 Oct;24(10):1902-1905. PMID: 36097872
MH  - Humans
MH  - Female
MH  - Stroke Volume
MH  - *Heart Failure
MH  - Ventricular Function, Left
MH  - New York
PMC - PMC9804680
OTO - NOTNLM
OT  - Dapagliflozin
OT  - Functional status
OT  - Heart failure with preserved ejection fraction
OT  - New York Heart Association classification
EDAT- 2022/09/03 06:00
MHDA- 2022/11/29 06:00
PMCR- 2022/12/31
CRDT- 2022/09/02 13:44
PHST- 2022/08/01 00:00 [revised]
PHST- 2022/07/23 00:00 [received]
PHST- 2022/08/06 00:00 [accepted]
PHST- 2022/09/03 06:00 [pubmed]
PHST- 2022/11/29 06:00 [medline]
PHST- 2022/09/02 13:44 [entrez]
PHST- 2022/12/31 00:00 [pmc-release]
AID - EJHF2652 [pii]
AID - 10.1002/ejhf.2652 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2022 Oct;24(10):1892-1901. doi: 10.1002/ejhf.2652. Epub 2022 
      Aug 27.