![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](https://image.slidesharecdn.com/4-190901181729/85/DAPA-HF-Trial-10-320.jpg)
Uploaded bySociedad Española de Cardiología
DAPA-HF Trial
The DAPA-HF study presented by Alfonso Valle McMurray at ESC 2019 evaluated the effects of dapagliflozin in patients with heart failure and reduced ejection fraction. Results indicated that the drug reduced the composite outcome of cardiovascular death or heart failure exacerbation by 26%, decreased the risk of first heart failure hospitalization by 30%, and showed significant improvements in patient-reported outcomes. Additionally, there was a nominally significant 17% reduction in all-cause mortality.
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DAPA-HF Trial
- 1. Alfonso Valle McMurray presentationESC 2019. Estudio DAPA-HF
- 2. Alfonso Valle McMurray presentationESC 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. Alfonso Valle McMurray presentationESC 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. Alfonso Valle McMurray presentationESC 2019. Estudio DAPA-HF
- 5. Alfonso Valle McMurray presentationESC 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. Alfonso Valle McMurray presentationESC 2019. Estudio DAPA-HF
- 7. Alfonso Valle McMurray presentationESC 2019. Primary composite outcome Estudio DAPA-HF
- 8. Alfonso Valle McMurray presentationESC 2019. Primary composite outcome Estudio DAPA-HF
- 9. Alfonso Valle McMurray presentationESC 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. Alfonso Valle McMurray presentationESC 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. Alfonso Valle McMurray presentationESC 2019. CV death or HF hospitalization Estudio DAPA-HF
- 12. Alfonso Valle McMurray presentationESC 2019. Total HF hospitalizations and CV death Including first and repeat hospitalizations Estudio DAPA-HF
- 13. Alfonso Valle McMurray presentationESC 2019. Worsening renal function endpoint Estudio DAPA-HF
- 14. Alfonso Valle McMurray presentationESC 2019. Kansas City Cardiomyopathy Questionnaire (KCCQ) Total Symptom Score: Proportion with ≥5 point change from baseline to 8 months* Estudio DAPA-HF
- 15. Alfonso Valle McMurray presentationESC 2019. All-cause death Estudio DAPA-HF
- 16. Alfonso Valle McMurray presentationESC 2019. Estudio DAPA-HF
- 17. Alfonso Valle • Dapagliflozinaañadido 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