4.5 Article

Effect of Dapagliflozin, Compared With Placebo, According to Baseline Risk in DAPA-HF

Journal

JACC-HEART FAILURE
Volume 10, Issue 2, Pages 104-118

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.jchf.2021.09.002

Keywords

heart failure; MAGGIC; PREDICT-HF; prognostic model; risk score; sodium-glucose cotransporter 2 inhibitor; survival; paper

Funding

  1. AstraZeneca
  2. British Heart Foundation Centre of Research Excellence Grant [RE/18/6/34217]
  3. Boehringer Ingelheim
  4. Hikma
  5. Lupin
  6. Sun Pharmaceuticals
  7. Medscape/Heart.Org
  8. ProAdWise Communications
  9. Radcliffe Cardiology
  10. Servier
  11. Corpus

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The MAGGIC score is positively associated with the relative risk of the primary endpoint. Dapagliflozin treatment provides similar benefits for the primary endpoint across the spectrum of MAGGIC risk score.
RESULTS The MAGGIC score was available for 4,740 of 4,744 patients in DAPA-HF (median score 22 [IQR: 18-25]). A1-point increase was associated with an 8.2% (95% CI: 6.9%-9.4%) higher relative risk of the primary endpoint (P < 0.001). The benefit of dapagliflozin over placebo for the primary endpoint was similar across the spectrum of MAGGIC risk score (interaction P 1/4 0.71). Applying the overall relative risk reduction (26%) with dapagliflozin added to standard therapy resulted in 7 fewer patients in the highest MAGGIC risk quintile experiencing a primary outcome, compared with 2 in the lowest quintile, per 100 person-years of treatment. The findings with PREDICT-HF were similar, although this model led to better risk discrimination.

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