Evidence map›Paper›PMID 32673497›Full record

Trial reportCirculation2020

Dapagliflozin and Diuretic Use in Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF.

Alice M Jackson, Pooja Dewan, Inder S Anand, Jan Bělohlávek, Olof Bengtsson, Rudolf A de Boer, Michael Böhm, David W Boulton, Vijay K Chopra, David L DeMets and 20 more

Erratum issued 3 registry-linked trialsOpen access · hybridAbstract readMulticenter StudyRandomized 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. An erratum has been issued. It reports registered trial NCT03036124. Cited by 61 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 2 pooled it
18.4field-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.

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
NCT06286878 phase2 / phase3recruitingstarted 2021, after this paper: background citation

Pleiotropic Effects of Dapagliflozin in Patients With Acute Coronary Syndromes

Ran2021Enrolled80Registered outcomes4Posted comparisons0ConditionsAcute Coronary Syndrome, Diabetes, Myocardial Infarction, Ventricular DysfunctionArmsdapagliflozin, Placebo
PMID 14502100PMID 28605608PMID 21205121PMID 26026848PMID 27295427PMID 28522450PMID 11602624PMID 24026259PMID 23992602PMID 23992601PMID 23598457PMID 23355343other papers from this trial
Open the trial in the graph
NCT05964738 phase2completednot on this mapstarted 2022, after this paper: background citation

Safety and Tolerability of Diuretics Withdrawal in Heart Failure With Reduced Ejection Fraction. REDICAE Trial.

TypeinterventionalSponsorMaimónides Biomedical Research Institute of CórdobaRan2022 to 2024Enrolled98ConditionsHeart Failure, Electric Impedance, Dyspnea, SafetyArmsDiuretics withdrawal, Diuretics maintenance
3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 172 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Effect of dapagliflozin on anaemia in DAPA-HF.European journal of heart failure · 2021
    Trial
  6. Trial
  7. Trial
  8. Trial
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Dapagliflozin and Cardiac Reverse Remodeling: New Insights in the Mechanistic Puzzle of SGLT2 Inhibitors.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2025
    Article
  15. Review
  16. Review
  17. Proximal versus distal diuretics in congestive heart failure.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024
    Review
  18. Review
  19. Article
  20. SGLT2 Inhibitors - The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024
    Review

1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors at 20 institutions in 16 countries.

Alice M JacksonBHF Cardiovascular Research Centre, University of Glasgow, UK (A.M.J., P.D., K.F.D., P.S.J., J.J.V.M.).
Pooja DewanBHF Cardiovascular Research Centre, University of Glasgow, UK (A.M.J., P.D., K.F.D., P.S.J., J.J.V.M.).
Inder S AnandDepartment of Cardiology, University of Minnesota, Minneapolis (I.S.A.).
Jan Bělohlávek2nd Department of Internal Medicine, Cardiovascular Medicine, General Teaching Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic (J.B.).
Olof BengtssonLate Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D (O.B., A.M.L., D.L., M.S.), AstraZeneca, Gothenburg, Sweden.
Rudolf A de BoerDepartment of Cardiology, University Medical Center and University of Groningen, The Netherlands (R.A.d.B.).
Michael BöhmDepartment of Medicine, Saarland University Hospital, Homburg-Saar, Germany (M.B.).
David W BoultonQuantitative Clinical Pharmacology, IMED Biotech Unit, Astra-Zeneca, Gaithersburg, MD (D.W.B.).
Vijay K ChopraDepartment of Cardiology, Medanta, Gurgaon, India (V.K.C.).
David L DeMetsDepartment of Biostatistics and Medical Informatics, University of Wisconsin, Madison (D.L.D.).
Kieran F DochertyBHF Cardiovascular Research Centre, University of Glasgow, UK (A.M.J., P.D., K.F.D., P.S.J., J.J.V.M.).
Andrej Dukát5th Department of Internal Medicine, Comenius University in Bratislava, Slovakia (A.D.).
Peter J GreasleyCardiovascular, Renal and Metabolism Translational Medicines Unit, Early Clinical Development, IMED Biotech Unit (P.J.G.), AstraZeneca, Gothenburg, Sweden.
Jonathan G HowlettCumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, AB, Canada (J.G.W.).
Silvio E InzucchiSection of Endocrinology, Yale University School of Medicine, New Haven, CT (S.E.I.).
Tzvetana KatovaClinic of Cardiology, National Cardiology Hospital, Sofia, Bulgaria (T.K.).
Lars KøberRigshospitalet Copenhagen University Hospital, Denmark (L.K.).
Mikhail N KosiborodSaint Luke's Mid America Heart Institute, University of Missouri, Kansas City (M.N.K.).
Anna Maria LangkildeLate Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D (O.B., A.M.L., D.L., M.S.), AstraZeneca, Gothenburg, Sweden.
Daniel LindholmLate Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D (O.B., A.M.L., D.L., M.S.), AstraZeneca, Gothenburg, Sweden.
Charlotta E A LjungmanDepartment of Molecular and Clinical Medicine and Cardiology, Sahlgrenska Academy, Gothenburg, Sweden (C.E.A.L.).
Felipe A MartinezNational University of Cordoba, Argentina (F.A.M.).
Eileen O'MearaDepartment of Cardiology, Montreal Heart Institute, QC, Canada (E.O.).
Marc S SabatineDivision of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.S.S., S.D.S.).
Mikaela SjöstrandLate Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D (O.B., A.M.L., D.L., M.S.), AstraZeneca, Gothenburg, Sweden.
Scott D SolomonDivision of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.S.S., 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, ON, Canada (S.V.).
Pardeep S JhundBHF Cardiovascular Research Centre, University of Glasgow, UK (A.M.J., P.D., K.F.D., P.S.J., J.J.V.M.).
John J V McMurrayBHF Cardiovascular Research Centre, University of Glasgow, UK (A.M.J., P.D., K.F.D., P.S.J., J.J.V.M.).
University of Glasgow · GBAstraZeneca (Finland) · FIAstraZeneca (Japan) · JPBrigham and Women's Hospital · USCharles University · CZComenius University Bratislava · SKCopenhagen University Hospital · DKLibin Cardiovascular Institute of Alberta · CAMedanta The Medicity · INMontreal Heart Institute · CANational Heart Hospital · BGNational Medical Research Center of Cardiology · RUSaarland University · DESahlgrenska University Hospital · SESaint Luke's Health System · USSt. Michael's Hospital · CAUniversidad Nacional de Córdoba · ARUniversity Medical Center Groningen · NLUniversity of Minnesota · USUniversity of Wisconsin–Madison · US

Funding

British Heart Foundation FS/18/14/33330British Heart Foundation RE/18/6/34217
6 · The paper itself

Abstract

backgroundIn the DAPA-HF trial (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure), the sodium-glucose cotransporter 2 inhibitor dapagliflozin reduced the risk of worsening heart failure and death in patients with heart failure and reduced ejection fraction. We examined the efficacy and tolerability of dapagliflozin in relation to background diuretic treatment and change in diuretic therapy after randomization to dapagliflozin or placebo.

methodsWe examined the effects of study treatment in the following subgroups: no diuretic and diuretic dose equivalent to furosemide <40, 40, and >40 mg daily at baseline. We examined the primary composite end point of cardiovascular death or a worsening heart failure event and its components, all-cause death and symptoms.

resultsOf 4616 analyzable patients, 736 (15.9%) were on no diuretic, 1311 (28.4%) were on <40 mg, 1365 (29.6%) were on 40 mg, and 1204 (26.1%) were taking >40 mg. Compared with placebo, dapagliflozin reduced the risk of the primary end point across each of these subgroups: hazard ratios were 0.57 (95% CI, 0.36-0.92), 0.83 (95% CI, 0.63-1.10), 0.77 (95% CI, 0.60-0.99), and 0.78 (95% CI, 0.63-0.97), respectively (

conclusionsThe efficacy and safety of dapagliflozin were consistent across the diuretic subgroups examined in DAPA-HF. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03036124.

Indexed as

AgedAged, 80 and overBenzhydryl CompoundsDiureticsFemaleGlucosidesHeart FailureHumansMaleMiddle AgedStroke VolumeBenzhydryl CompoundsdapagliflozinDiureticsGlucosidesdiureticsheart failuresodium-glucose transporter 2 inhibitors

Identifiers

PMID32673497
PMCPMC7664959
OpenAlexW3042528593

What Socratic holds

Textmetadata
LicenceCC BY
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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 Socratic graph.