Efficacy and safety of dapagliflozin according to aetiology in heart failure with reduced ejection fraction: insights from the <scp>DAPA‐HF</scp> trial

Aims We examined the efficacy and safety of dapagliflozin, compared with placebo, according to aetiology in patients heart failure (HF) reduced ejection fraction (HFrEF) enrolled Dapagliflozin And Prevention Adverse-outcomes Heart Failure trial (DAPA-HF). Methods results Aetiology was investigator-reported categorized as ischaemic or non-ischaemic. The primary outcome composite an episode worsening HF cardiovascular death. A total 4744 were randomized DAPA-HF, whom 2674 (56.4%) had aetiology. Participants a higher risk mortality [hazard ratio (HR) 1.35, 95% confidence interval (CI) 1.13–1.63], but lower hospitalization (HR 0.83, CI 0.70–0.98) than non-ischaemic patients. Compared dapagliflozin death similar extent both 0.77, 0.65–0.92, HR 0.71, 0.58–0.87, respectively; P for interaction = 0.55). Consistent benefits observed components all-cause mortality. Dapagliflozin, increased proportion improvement Kansas City Cardiomyopathy Questionnaire symptom score (KCCQ-TSS) ≥5 points (P 0.32) decreased deterioration KCCQ-TSS 0.76), irrespective Study drug discontinuation serious adverse events treatment groups, Conclusions death, improved symptoms, similarly In addition, safe well-tolerated,