Evidence mapPaperPMID 40958495Full record

Trial reportESC heart failure2025

Cardiometabolic outcomes with dapagliflozin after myocardial infarction by baseline ejection fraction: DAPA-MI.

David Erlinge, Stefan James, John Deanfield, Niclas Eriksson, Mark de Belder, Monér Alchay, David Austin, Daniel A Jones, Annica Ravn-Fischer, Sofia Sederholm Lawesson and 10 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
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

20 authors.

David ErlingeDepartment of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.ORCID https://orcid.org/0000-0003-3042-5766
Stefan JamesUppsala Clinical Research Center, Uppsala, Sweden.
John DeanfieldInstitute of Cardiovascular Sciences, University College London, London, UK.
Niclas ErikssonUppsala Clinical Research Center, Uppsala, Sweden.
Mark de BelderNational Institute for Cardiovascular Outcomes Research (NICOR), NHS Arden and Greater East Midlands Commissioning Support Unit, Leicester, UK.
Monér AlchayNorth Älvsborg County Hospital, Trollhättan, Sweden.
David AustinAcademic Cardiovascular Unit, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.
Daniel A JonesWilliam Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
Annica Ravn-FischerInstitute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Sofia Sederholm LawessonDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Nikunj ShahQueen Alexandra Hospital, Portsmouth, UK.
Julian W StrangeDepartment of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Foundation Trust, Bristol, UK.
Karolina SzummerDepartment of Cardiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Wilhelm RidderstråleLate-Stage Development, Cardiovascular, Renal and Metabolism, Bio-Pharmaceuticals Research and Development, AstraZeneca, Gothenburg, Sweden.
Ehsan Parvaresh RiziLate-Stage Development, Cardiovascular, Renal and Metabolism, Bio-Pharmaceuticals Research and Development, AstraZeneca, Gothenburg, Sweden.
Anna Maria LangkildeLate-Stage Development, Cardiovascular, Renal and Metabolism, Bio-Pharmaceuticals Research and Development, AstraZeneca, Gothenburg, Sweden.
Peter A JohanssonLate-Stage Development, Cardiovascular, Renal and Metabolism, Bio-Pharmaceuticals Research and Development, AstraZeneca, Gothenburg, Sweden.
Darren K McGuireDivision of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Jonas OldgrenUppsala Clinical Research Center, Uppsala, Sweden.
Robert F StoreyDivision of Clinical Medicine, University of Sheffield, Sheffield, UK.

Funding

AstraZeneca
6 · The paper itself

Abstract

aimsIn the randomized DAPA-MI clinical trial, 10 mg of dapagliflozin once daily improved cardiometabolic outcomes versus placebo after acute myocardial infarction (MI) in patients without established diabetes or heart failure (HF). We assessed associations between baseline left ventricular ejection fraction (LVEF) and cardiometabolic outcomes in DAPA-MI.

methodsThe primary outcome, assessed using the win ratio method, was the hierarchical composite of death, hospitalization for HF, non-fatal MI, atrial fibrillation/flutter, Type 2 diabetes, New York Heart Association classification at last visit and body weight decrease of ≥5% from baseline to last visit. For the present analysis, patients were categorized using LVEF at randomization (<50% or ≥50%).

resultsOf the DAPA-MI participants with available LVEF data who received ≥1 dose of study drug (n = 3751), 2913 (77.7%) had LVEF <50% and 838 (22.3%) had LVEF ≥50%. The primary hierarchical composite outcome resulted in a win ratio favouring dapagliflozin of 1.38 (95% CI: 1.21, 1.57; P < 0.001) in patients with LVEF <50% and 1.32 (1.00, 1.73; P = 0.048) in patients with LVEF ≥ 50% (P interaction = 0.76). In a sensitivity analysis excluding patients with LVEF <30%, the primary hierarchical composite outcome resulted in a win ratio favouring dapagliflozin of 1.40 (95% CI: 1.22, 1.61; P < 0.001). There were no significant interactions between baseline LVEF and any secondary outcomes.

conclusionsRegardless of baseline LVEF, dapagliflozin resulted in significant cardiometabolic benefits versus placebo, although there was no impact on the composite of cardiovascular death or hospitalization for HF.

Indexed as

Benzhydryl CompoundsGlucosidesMyocardial InfarctionStroke VolumeVentricular Function, LeftAgedDouble-Blind MethodFemaleFollow-Up StudiesHumansMaleMiddle AgedSodium-Glucose Transporter 2 InhibitorsTreatment OutcomeBenzhydryl CompoundsdapagliflozinGlucosidesSodium-Glucose Transporter 2 Inhibitorsdapagliflozinheart failureleft ventricular ejection fractionmyocardial infarctionsodium–glucose cotransporter‐2 inhibitors

Identifiers

PMID40958495
PMCPMC12719873

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.