Puesta al día sobre el empleo de dapagliflozina en insuficiencia cardiaca con fracción de eyección reducida

Abstract

Despite progress in the treatment of heart failure with reduced ejection fraction (HFrEF), mortality and hospitalization rates remain very high. The DAPA-HF trial demonstrated that, compared with standard treatment, the addition of dapagliflozin, 10 mg/day, was associated with marked clinical benefits in patients with HFrEF. Significant reductions were observed in several outcomes: (i) a 26% reducción in the risk of cardiovascular death, hospitalization or an emergency department visit for heart failure that resulted in intravenous treatment; (ii) a 30% reduccion in the risk of a first hospitalization for heart failure; (iii) an 18% reduccion in cardiovascular mortality; and (iv) a 17% reduccion in all-cause mortality. In addition, the adverse event rate was low. These beneficial effects were independent of the presence of diabetes. Moreover, it was found that the earlier treatment with dapagliflozin was started, the greater the benefit, irrespective of the patient’s existing treatment for heart failure. This article provides an update on dapagliflozin treatment for patients with HFrEF and presents recommendations on the drug’s use in practice.