دورية أكاديمية
Influence of NT-proBNP on Efficacy of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction
| العنوان: | Influence of NT-proBNP on Efficacy of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction |
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| المؤلفون: | Myhre, Peder L., Vaduganathan, Muthiah, Claggett, Brian L., Miao, Zi Michael, Jhund, Pardeep S., de Boer, Rudolf A., Hernandez, Adrian F., Inzucchi, Silvio E., Kosiborod, Mikhail N., Lam, Carolyn S.P., Martinez, Felipe, Shah, Sanjiv J., Desai, Akshay S., Lindholm, Daniel, Petersson, Magnus, Langkilde, Anna Maria, McMurray, John J.V., Solomon, Scott D. |
| المصدر: | Myhre , P L , Vaduganathan , M , Claggett , B L , Miao , Z M , Jhund , P S , de Boer , R A , Hernandez , A F , Inzucchi , S E , Kosiborod , M N , Lam , C S P , Martinez , F , Shah , S J , Desai , A S , Lindholm , D , Petersson , M , Langkilde , A M , McMurray , J J V & Solomon , S D 2022 , ' Influence of NT-proBNP on Efficacy of Dapagliflozin in .... |
| سنة النشر: | 2022 |
| المجموعة: | University of Groningen research database |
| مصطلحات موضوعية: | clinical trial, dapagliflozin, HFmrEF, HFpEF, NT-proBNP, SGLT2 inhibitors |
| الوصف: | Background: N-terminal pro–B-type natriuretic peptide (NT-proBNP) is used for diagnostic and prognostic evaluation in heart failure (HF). Previous clinical trials in heart failure with mildly reduced ejection fraction (HFmrEF) or heart failure with preserved ejection fraction (HFpEF) have shown potential heterogeneity in the treatment response by baseline NT-proBNP levels. Objectives: The purpose of this study was to assess the treatment effect of dapagliflozin across baseline levels of NT-proBNP among patients with HFmrEF or HFpEF. Methods: This was a post hoc analysis from DELIVER (Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure), a randomized, placebo-controlled trial of dapagliflozin in patients with HFmrEF or HFpEF. Elevated NT-proBNP was part of the inclusion criteria (≥300 ng/L for non–atrial fibrillation or flutter [AFF]; ≥600 ng/L for AFF). Baseline NT-proBNP was categorized in quartiles and additionally analyzed continuously. The primary composite outcome was cardiovascular death or worsening HF events. Results: Among the 6,262 included patients (mean: 71.7 years and 3,516 [56%] men), the median baseline concentration of NT-proBNP was 716 (Q1-Q3: 469-1,280) ng/L and 1,399 (Q1-Q3: 962-2,212) ng/L for non-AFF and AFF, respectively. Higher NT-proBNP levels were linearly associated with a greater risk of the primary outcome (adjusted HR for log 2 NTpro-BNP was 1.53 [95% CI: 1.46-1.62] and Q4 vs Q1: 3.46 [95% CI: 2.48-4.22]; P < 0.001), with consistent results regardless of AFF status. The clinical benefit of dapagliflozin was present irrespective of baseline NT-proBNP concentration (P value for interaction = 0.40 by quartiles and = 0.19 continuously for the primary outcome) and the absolute risk reduction was, therefore, greater with higher NT-proBNP concentrations. The effect on health status and safety of dapagliflozin was similarly consistent across NT-proBNP quartiles. Conclusions: Dapagliflozin is safe and improves outcomes irrespective of ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://research.rug.nl/en/publications/7e7bc6c1-bcd5-4f5d-b7d9-40032b6e7481Test |
| DOI: | 10.1016/j.jchf.2022.08.007 |
| الإتاحة: | https://doi.org/10.1016/j.jchf.2022.08.007Test https://hdl.handle.net/11370/7e7bc6c1-bcd5-4f5d-b7d9-40032b6e7481Test https://research.rug.nl/en/publications/7e7bc6c1-bcd5-4f5d-b7d9-40032b6e7481Test https://pure.rug.nl/ws/files/654912460/1_s2.0_S221317792200470X_main.pdfTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.663499C |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jchf.2022.08.007 |
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