TY - JOUR
T1 - Effects of Dapagliflozin in Patients in Asia
T2 - A Post Hoc Subgroup Analysis From the DELIVER Trial
AU - Wang, Xiaowen
AU - Lam, Carolyn S.P.
AU - Vaduganathan, Muthiah
AU - Kondo, Toru
AU - Yang, Mingming
AU - Han, Yaling
AU - Pham, Vinh Nguyen
AU - Chiang, Chern En
AU - Kitakaze, Masafumi
AU - Miao, Zi Michael
AU - Jhund, Pardeep S.
AU - Desai, Akshay S.
AU - Inzucchi, Silvio E.
AU - de Boer, Rudolf A.
AU - Martinez, Felipe A.
AU - Kosiborod, Mikhail N.
AU - Hernandez, Adrian F.
AU - Claggett, Brian
AU - Langkilde, Anna Maria
AU - McMurray, John J.V.
AU - Solomon, Scott D.
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/2
Y1 - 2024/2
N2 - Background: Patients with heart failure (HF) with mildly reduced or preserved ejection fraction in Asia may have different clinical characteristics and outcomes compared with patients from other parts of the world.Objectives: The purpose of this study was to investigate the clinical characteristics, safety, and efficacy of dapagliflozin in patients in Asia vs outside Asia in the DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients with Preserved Ejection Fraction Heart Failure) trial. Methods: In the DELIVER trial, patients with HF and left ventricular ejection fraction >40% were enrolled across 353 sites in 20 countries. The effects of dapagliflozin vs placebo on primary (composite of worsening HF or cardiovascular death) and secondary outcomes were compared in patients from Asia vs outside Asia. Results: Among 6,263 participants, 1,226 (19.6%) were enrolled in Asia. Participants from Asia were less likely to have diabetes, hypertension, history of myocardial infarction, or obesity. After adjusting for clinically relevant characteristics, those in Asia had similar risks of primary composite outcome compared with those from outside Asia (HR: 0.97; 95% CI: 0.82-1.15). Those in Asia had a lower risk of all-cause mortality compared with those enrolled outside Asia (HR: 0.54; 95% CI: 0.44-0.66). Enrollment from Asia did not modify the effect of dapagliflozin on the primary outcome (Pinteraction = 0.54). Serious adverse events and rates of drug discontinuation were also balanced in both treatment arms, irrespective of enrollment in Asia vs outside Asia. Conclusions: In the global DELIVER trial, dapagliflozin reduced the risk of CV death or worsening HF events and was well tolerated among participants enrolled in both Asia and other geographic regions.
AB - Background: Patients with heart failure (HF) with mildly reduced or preserved ejection fraction in Asia may have different clinical characteristics and outcomes compared with patients from other parts of the world.Objectives: The purpose of this study was to investigate the clinical characteristics, safety, and efficacy of dapagliflozin in patients in Asia vs outside Asia in the DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients with Preserved Ejection Fraction Heart Failure) trial. Methods: In the DELIVER trial, patients with HF and left ventricular ejection fraction >40% were enrolled across 353 sites in 20 countries. The effects of dapagliflozin vs placebo on primary (composite of worsening HF or cardiovascular death) and secondary outcomes were compared in patients from Asia vs outside Asia. Results: Among 6,263 participants, 1,226 (19.6%) were enrolled in Asia. Participants from Asia were less likely to have diabetes, hypertension, history of myocardial infarction, or obesity. After adjusting for clinically relevant characteristics, those in Asia had similar risks of primary composite outcome compared with those from outside Asia (HR: 0.97; 95% CI: 0.82-1.15). Those in Asia had a lower risk of all-cause mortality compared with those enrolled outside Asia (HR: 0.54; 95% CI: 0.44-0.66). Enrollment from Asia did not modify the effect of dapagliflozin on the primary outcome (Pinteraction = 0.54). Serious adverse events and rates of drug discontinuation were also balanced in both treatment arms, irrespective of enrollment in Asia vs outside Asia. Conclusions: In the global DELIVER trial, dapagliflozin reduced the risk of CV death or worsening HF events and was well tolerated among participants enrolled in both Asia and other geographic regions.
UR - https://www.scopus.com/pages/publications/85183648956
U2 - 10.1016/j.jacasi.2023.10.005
DO - 10.1016/j.jacasi.2023.10.005
M3 - Article
C2 - 38371292
AN - SCOPUS:85183648956
SN - 2772-3747
VL - 4
SP - 108
EP - 118
JO - JACC: Asia
JF - JACC: Asia
IS - 2
ER -
