Evidence map›Paper›PMID 32883108›Full record

Trial reportCirculation2020

Effect of Dapagliflozin on Outpatient Worsening of Patients With Heart Failure and Reduced Ejection Fraction: A Prespecified Analysis of DAPA-HF.

Kieran F Docherty, Pardeep S Jhund, Inder Anand, Olof Bengtsson, Michael Böhm, Rudolf A de Boer, David L DeMets, Akshay S Desai, Jaroslaw Drozdz, Jonathan Howlett and 18 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03036124. Cited by 37 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 1 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03036124 phase3completed

Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients With Chronic Heart Failure With Reduced Ejection Fraction

Ran2017Enrolled4,744Registered outcomes6Posted comparisons6ConditionsChronic Heart Failure With Reduced Ejection Fraction (HFrEF)Armsdapagliflozin, Placebo
Open the trial in the graph
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 1 synthesis or guideline pooled it, 84 citations in OpenAlex.

  1. Pooled it
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  14. Impact of SGLT2 inhibitor on clinical and echocardiographic outcomes in patients with CRT during long-term period.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 20 institutions in 15 countries.

Kieran F Docherty *British Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK (K.F.D., P.S.J., J.J.V.M.).
Pardeep S Jhund *British Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK (K.F.D., P.S.J., J.J.V.M.).
Inder AnandDepartment of Cardiology, University of Minnesota, Minneapolis (I.A.).
Olof BengtssonLate Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden (O.B., P.J., A.M.L., D.L., M.S.).
Michael BöhmDepartment of Medicine, Saarland University Hospital, Homburg/Saar, Germany (M.B.).
Rudolf A de BoerDepartment of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (R.A.d.B.).
David L DeMetsDepartment of Biostatistics & Medical Informatics, University of Wisconsin, Madison (D.L.D.).
Akshay S DesaiCardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.S.D., S.D.S.).
Jaroslaw DrozdzDepartment of Cardiology, Medical University of Lodz, Poland (J.D.).
Jonathan HowlettUniversity of Calgary, Cumming School of Medicine and Libin Cardiovascular Institute, Alberta, Canada (J.H.).
Silvio E InzucchiSection of Endocrinology, Yale University School of Medicine, New Haven, CT (S.E.I.).
Per JohansonLate Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden (O.B., P.J., A.M.L., D.L., M.S.).
Tzvetana KatovaClinic of Cardiology, National Cardiology Hospital, Sofia, Bulgaria (T.K.).
Lars KøberDepartment of Cardiology Copenhagen University Hospital, Denmark (L.K.).
Mikhail N KosiborodSaint Luke's Mid America Heart Institute and University of Missouri-Kansas City (M.N.K.).
Anna Maria LangkildeLate Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden (O.B., P.J., A.M.L., D.L., M.S.).
Daniel LindholmLate Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden (O.B., P.J., A.M.L., D.L., M.S.).
Felipe A MartinezUniversidad Nacional de Córdoba, Argentina (F.A.M.).
Béla MerkelyHeart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.).
Jose C NicolauInstituto do Coracao (InCor), Hospital das Clínicas Faculdade de Medicina, Universidade de São Paulo, Brazil (J.C.N.).
Eileen O'MearaDepartment of Cardiology, Montreal Heart Institute, Ontario, Canada (E.O'M.).
Piotr PonikowskiCenter for Heart Diseases, University Hospital, Wroclaw Medical University, Poland (P.P.).
Marc S SabatineTIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.S.S.).
Mikaela SjöstrandLate Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden (O.B., P.J., A.M.L., D.L., M.S.).
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.S.D., S.D.S.).
Sergey TereshchenkoDepartment of Myocardial Disease and Heart Failure, National Medical Research Center of Cardiology, Moscow, Russia (S.T.).
Subodh VermaDivision of Cardiac Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada (S.V.).
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK (K.F.D., P.S.J., J.J.V.M.).
AstraZeneca (Finland) · FIBrigham and Women's Hospital · USBritish Heart Foundation · GBCopenhagen University Hospital · DKHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRLibin Cardiovascular Institute of Alberta · CAMedical University of Lodz · PLMontreal Heart Institute · CANational Heart Hospital · BGNational Medical Research Center of Cardiology · RUSaarland University · DESemmelweis University · HUSt. Michael's Hospital · CAThe George Institute for Global Health · AUUniversidad Nacional de Córdoba · ARUniversity Medical Center Groningen · NLUniversity of Minnesota · USUniversity of Wisconsin–Madison · USWroclaw Medical University · PLYale University · US

Funding

Yale Diabetes Research CenterP30DK045735 · NIDDK · YALE UNIVERSITY · PI Kevan C Herold, GERALD I SHULMAN · 1993 to 2026
$44.0M
British Heart Foundation RE/18/6/34217NIDDK NIH HHS P30 DK045735
6 · The paper itself

Abstract

backgroundIn the DAPA-HF trial (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure), dapagliflozin, added to guideline-recommended therapies, reduced the risk of mortality and heart failure (HF) hospitalization. We examined the frequency and significance of episodes of outpatient HF worsening, requiring the augmentation of oral therapy, and the effects of dapagliflozin on these additional events.

methodsPatients in New York Heart Association functional class II to IV, with a left ventricular ejection fraction ≤40% and elevation of NT-proBNP (N-terminal pro-B-type natriuretic peptide), were eligible. The primary outcome was the composite of an episode of worsening HF (HF hospitalization or an urgent HF visit requiring intravenous therapy) or cardiovascular death, whichever occurred first. An additional prespecified exploratory outcome was the primary outcome plus worsening HF symptoms/signs leading to the initiation of new, or the augmentation of existing, oral treatment.

resultsOverall, 36% more patients experienced the expanded, in comparison with the primary, composite outcome. In the placebo group, 684 of 2371 (28.8%) patients and, in the dapagliflozin group, 527 of 2373 (22.2%) participants experienced the expanded outcome (hazard ratio, 0.73 [95% CI, 0.65-0.82];

conclusionIn DAPA-HF, outpatient episodes of HF worsening were common, were of prognostic importance, and were reduced by dapagliflozin. Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT03036124.

Indexed as

AgedBenzhydryl CompoundsDouble-Blind MethodGlucosidesHeart FailureHumansOutpatientsProspective StudiesSodium-Glucose Transporter 2 InhibitorsStroke VolumeBenzhydryl CompoundsdapagliflozinGlucosidesSodium-Glucose Transporter 2 Inhibitorsheart failurehospitalizationsodium-glucose transporter 2 inhibitorstherapytreatment outcome

Identifiers

PMID32883108
PMCPMC7580857
OpenAlexW3083153332

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.