Evidence map›Paper›PMID 38569758›Full record

Trial reportJournal of the American College of Cardiology2024

Efficacy and Safety of Dapagliflozin in Patients With Acute Heart Failure.

Zachary L Cox, Sean P Collins, Gabriel A Hernandez, A Thomas McRae, Beth T Davidson, Kirkwood Adams, Mark Aaron, Luke Cunningham, Cathy A Jenkins, Christopher J Lindsell and 5 more

2 registry-linked trialsAbstract readRandomized Controlled TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT04298229. Cited by 86 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 11 pooled it
39.3field-weighted citation impact, top 1% 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.

NCT04298229 phase3completed

A Randomized, Open-label Study of Dapagliflozin in Patients With or Without Type 2 Diabetes Admitted With Acute Heart Failure

Ran2020Enrolled240Registered outcomes3Posted comparisons0ConditionsDiabetes Mellitus, Type 2, Heart FailureArmsDapagliflozin 10 mg, Protocolized Diuretic Therapy
PMID 27266853PMID 26299229PMID 26041600PMID 25838436PMID 25287144PMID 24879974PMID 24585267PMID 24379278PMID 24247300PMID 23356556PMID 23333145PMID 23141816other papers from this trial
Open the trial in the graph
NCT06535529 phase3recruiting

Acetazolamide Versus Dapagliflozin in Acute Decompensated Heart Failure Patients

Ran2024Enrolled60Registered outcomes8Posted comparisons0ConditionsAcute Decompensated Heart FailureArmsAcetazolamide, Dapagliflozin 10mg
PMID 30238574PMID 36027559PMID 37207453PMID 37213994PMID 37415505PMID 38202295PMID 38416359other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 11 syntheses or guidelines pooled it, 110 citations in OpenAlex.

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  12. Abnormal "Frontiers in cardiovascular medicine · 2026
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  20. PaOCJC open · 2026
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26 more citing papers are in PubMed but not listed here.

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

15 authors at 8 institutions in 1 country.

Zachary L CoxDepartment of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, Tennessee, USA; Department of Pharmacy, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: Zachary.l.cox@vumc.org.
Sean P CollinsDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Veterans Affairs Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center, Nashville, Tennessee, USA.
Gabriel A HernandezDivision of Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
A Thomas McRaeTriStar Centennial Medical Center, Nashville, Tennessee, USA.
Beth T DavidsonTriStar Centennial Medical Center, Nashville, Tennessee, USA.
Kirkwood AdamsDepartment of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Mark AaronDepartment of Cardiac Sciences, Saint Thomas West Hospital, Nashville, Tennessee, USA.
Luke CunninghamDepartment of Cardiology, INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma, USA.
Cathy A JenkinsDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Christopher J LindsellDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Frank E HarrellDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Christina KampeDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Karen F MillerDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
William B StubblefieldDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
JoAnn LindenfeldDivision of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Vanderbilt University Medical Center · USCentennial Medical Center · USINTEGRIS Baptist Medical Center · USLipscomb University · USSaint Thomas West Hospital · USUniversity of Mississippi Medical Center · USUniversity of North Carolina at Chapel Hill · USVA Tennessee Valley Healthcare System · US

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
NCATS NIH HHS UL1 TR000445
6 · The paper itself

Abstract

backgroundThe primary goals during acute heart failure (AHF) hospitalization are decongestion and guideline-directed medical therapy (GDMT) optimization. Unlike diuretics or other GDMT, early dapagliflozin initiation could achieve both AHF goals.

objectivesThe authors aimed to assess the diuretic efficacy and safety of early dapagliflozin initiation in AHF.

methodsIn a multicenter, open-label study, 240 patients were randomized within 24 hours of hospital presentation for hypervolemic AHF to dapagliflozin 10 mg once daily or structured usual care with protocolized diuretic titration until day 5 or hospital discharge. The primary outcome, diuretic efficiency expressed as cumulative weight change per cumulative loop diuretic dose, was compared across treatment assignment using a proportional odds model adjusted for baseline weight. Secondary and safety outcomes were adjudicated by a blinded committee.

resultsFor diuretic efficiency, there was no difference between dapagliflozin and usual care (OR: 0.65; 95% CI: 0.41-1.02; P = 0.06). Dapagliflozin was associated with reduced loop diuretic doses (560 mg [Q1-Q3: 260-1,150 mg] vs 800 mg [Q1-Q3: 380-1,715 mg]; P = 0.006) and fewer intravenous diuretic up-titrations (P ≤ 0.05) to achieve equivalent weight loss as usual care. Early dapagliflozin initiation did not increase diabetic, renal, or cardiovascular safety events. Dapagliflozin was associated with improved median 24-hour natriuresis (P = 0.03) and urine output (P = 0.005), expediting hospital discharge over the study period.

conclusionsEarly dapagliflozin during AHF hospitalization is safe and fulfills a component of GDMT optimization. Dapagliflozin was not associated with a statistically significant reduction in weight-based diuretic efficiency but was associated with evidence for enhanced diuresis among patients with AHF. (Efficacy and Safety of Dapagliflozin in Acute Heart Failure [DICTATE-AHF]; NCT04298229).

Indexed as

Benzhydryl CompoundsGlucosidesHeart FailureSodium Potassium Chloride Symporter InhibitorsAcute DiseaseDiureticsHumansBenzhydryl CompoundsdapagliflozinDiureticsGlucosidesSodium Potassium Chloride Symporter Inhibitorsacute heart failuredapagliflozindiuresisheart failureSGLT2i

Identifiers

PMID38569758
OpenAlexW4393377767

What OpenQuestion holds

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Read underepoch 390

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.