Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
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DOI：
10.1056/nejmoa1911303
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发表时间：
2019-11-21
影响因子：
158.5
通讯作者：
Langkilde, A. -M.
中科院分区：
文献类型：
--
作者：
McMurray, J. J. V.;Solomon, S. D.;Langkilde, A. -M.
BACKGROUNDIn patients with type 2 diabetes, inhibitors of sodium-glucose cotransporter 2 (SGLT2) reduce the risk of a first hospitalization for heart failure, possibly through glucose-independent mechanisms. More data are needed regarding the effects of SGLT2 inhibitors in patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes.METHODSIn this phase 3, placebo-controlled trial, we randomly assigned 4744 patients with New York Heart Association class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either dapagliflozin (at a dose of 10 mg once daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of worsening heart failure (hospitalization or an urgent visit resulting in intravenous therapy for heart failure) or cardiovascular death.RESULTSOver a median of 18.2 months, the primary outcome occurred in 386 of 2373 patients (16.3%) in the dapagliflozin group and in 502 of 2371 patients (21.2%) in the placebo group (hazard ratio, 0.74; 95% confidence interval [CI], 0.65 to 0.85; P
