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Alfonso Valle
McMurray presentation ESC 2019.
Estudio DAPA-HF
Alfonso Valle
McMurray presentation ESC 2019.
• Primary endpoint:
Worsening HF event or cardiovascular death (worsening HF...
Alfonso Valle
McMurray presentation ESC 2019.
•
•
•
•
•
•
Informed consent
Inclusion/exclusion
Clinical assessment
ECG
NT-...
Alfonso Valle
McMurray presentation ESC 2019.
Estudio DAPA-HF
Alfonso Valle
McMurray presentation ESC 2019.
Characteristic
Mean age (yr)
Male (%)
NYHA class II/III/IV (%)
Mean LVEF (%)...
Alfonso Valle
McMurray presentation ESC 2019.
Estudio DAPA-HF
Alfonso Valle
McMurray presentation ESC 2019.
Primary composite outcome
Estudio DAPA-HF
Alfonso Valle
McMurray presentation ESC 2019.
Primary composite outcome
Estudio DAPA-HF
Alfonso Valle
McMurray presentation ESC 2019.
No diabetes/diabetes subgroup:
Primary endpoint
*Defined as history of type ...
Alfonso Valle
McMurray presentation ESC 2019.
1.Time to the first occurrence of either of the components of the composite:...
Alfonso Valle
McMurray presentation ESC 2019.
CV death or HF hospitalization
Estudio DAPA-HF
Alfonso Valle
McMurray presentation ESC 2019.
Total HF hospitalizations and CV death
Including first and repeat hospitaliz...
Alfonso Valle
McMurray presentation ESC 2019.
Worsening renal function endpoint
Estudio DAPA-HF
Alfonso Valle
McMurray presentation ESC 2019.
Kansas City Cardiomyopathy Questionnaire (KCCQ)
Total Symptom Score: Proport...
Alfonso Valle
McMurray presentation ESC 2019.
All-cause death
Estudio DAPA-HF
Alfonso Valle
McMurray presentation ESC 2019.
Estudio DAPA-HF
Alfonso Valle
• Dapagliflozina añadido a TMO en pacientes con ICrFEVI, redujo el compuesto de muerte cardiovascular (CV) o...
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DAPA-HF Trial

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El Dr. Alfonso Valle Muñoz comenta los resultados del estudio con dapagliflozina en insuficiencia cardiaca, presentado en ESC Congress 2019.

Published in: Health & Medicine

DAPA-HF Trial

  1. 1. Alfonso Valle McMurray presentation ESC 2019. Estudio DAPA-HF
  2. 2. Alfonso Valle McMurray presentation ESC 2019. • Primary endpoint: Worsening HF event or cardiovascular death (worsening HF event = unplanned HF hospitalization or an urgent heart failure visit requiring intravenous therapy) Estudio DAPA-HF
  3. 3. Alfonso Valle McMurray presentation ESC 2019. • • • • • • Informed consent Inclusion/exclusion Clinical assessment ECG NT-proBNP Laboratory N=2371 N=2373 Placebo Dapagliflozin 10 mg once daily ≥844 Primary endpoints Composite of: • CV death • HF hospitalization • Urgent HF visit Visit 1 Day −14 Visit 5 Day 120 Visit 4 Day 60 Visit 2 Day 0 Visit 3 Day 14 Visit 6 etc. Every 120 days Enrolment Estudio DAPA-HF
  4. 4. Alfonso Valle McMurray presentation ESC 2019. Estudio DAPA-HF
  5. 5. Alfonso Valle McMurray presentation ESC 2019. Characteristic Mean age (yr) Male (%) NYHA class II/III/IV (%) Mean LVEF (%) Median NT pro BNP (pg/ml) Mean systolic BP (mmHg) Ischaemic aetiology (%) Mean eGFR (ml/min/1.73m2) Prior diagnosis T2D (%) Any baseline T2D (%)* Dapagliflozin (n=2373) 66 76 68/31/1 31 1428 122 55 66 42 45 Placebo (n=2371) 67 77 67/32/1 31 1446 122 57 66 42 45 Estudio DAPA-HF
  6. 6. Alfonso Valle McMurray presentation ESC 2019. Estudio DAPA-HF
  7. 7. Alfonso Valle McMurray presentation ESC 2019. Primary composite outcome Estudio DAPA-HF
  8. 8. Alfonso Valle McMurray presentation ESC 2019. Primary composite outcome Estudio DAPA-HF
  9. 9. Alfonso Valle McMurray presentation ESC 2019. No diabetes/diabetes subgroup: Primary endpoint *Defined as history of type 2 diabetes or HbA1c ≥6.5% at both enrollment and randomization visits. Estudio DAPA-HF
  10. 10. Alfonso Valle McMurray presentation ESC 2019. 1.Time to the first occurrence of either of the components of the composite: CV death or hospitalization for HF. 2.Total number of (first and recurrent) HF hospitalizations and CV death 3.Change from baseline measured at 8 months in the total symptom score of the Kansas City Cardiomyopathy Questionnaire (KCCQ), a specific HF patient reported outcome questionnaire. 4.Time to the first occurrence of any of the components of the composite: ≥50% sustained decline in eGFR or reaching End Stage Renal Disease (ESRD) or renal death. [ Time Frame: From randomization visit (day 0) up to approximately 3 years ]End Stage Renal Disease (ESRD) is defined as -Sustained eGFR <15 mL/min/1.73m^2 or, -Chronic dialysis treatment or, -Receiving a renal transplant 5. Time to death from any cause. Estudio DAPA-HF
  11. 11. Alfonso Valle McMurray presentation ESC 2019. CV death or HF hospitalization Estudio DAPA-HF
  12. 12. Alfonso Valle McMurray presentation ESC 2019. Total HF hospitalizations and CV death Including first and repeat hospitalizations Estudio DAPA-HF
  13. 13. Alfonso Valle McMurray presentation ESC 2019. Worsening renal function endpoint Estudio DAPA-HF
  14. 14. Alfonso Valle McMurray presentation ESC 2019. Kansas City Cardiomyopathy Questionnaire (KCCQ) Total Symptom Score: Proportion with ≥5 point change from baseline to 8 months* Estudio DAPA-HF
  15. 15. Alfonso Valle McMurray presentation ESC 2019. All-cause death Estudio DAPA-HF
  16. 16. Alfonso Valle McMurray presentation ESC 2019. Estudio DAPA-HF
  17. 17. Alfonso Valle • Dapagliflozina añadido a TMO en pacientes con ICrFEVI, redujo el compuesto de muerte cardiovascular (CV) o empeoramiento de la IC en un 26% (p <0,0001) y mostró una reducción en cada uno de los componentes individuales. • Disminuye un 30% (p <0,0001) en el riesgo de experimentar un primer episodio de IC y reduce el 18% (p = 0,0294) en el riesgo de muerte CV. • Resultados en RR y RA del riesgo de muerte u hospitalización por IC en los diferntes subgrupos, incluido en pacientes NO DIABÉTICOS • Mejora significativa KCCQ y una reducción nominalmente significativa en lamortalidad por todas las causas en un 17% (7.9 versus 9.5 pacientes con un evento por cada 100 pacientes años) Estudio DAPA-HF

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