Breaking News
April 18, 2019 - Diabetic drug shows potential to be repurposed as heart disease treatment for non-diabetic patients
April 18, 2019 - New estimation method assesses natural variations in sex ratio at birth
April 18, 2019 - UTA scientist receives $1.17 million grant for cancer research
April 18, 2019 - Coagulation factor VIIa prevents bleeds in hemophilia animal models
April 18, 2019 - Researchers identify risk factors for severe infection after knee replacement
April 18, 2019 - Mass drug administration can offer community-level protection against malaria
April 18, 2019 - FDA’s added sugar label could have substantial health and cost-saving benefits
April 18, 2019 - Researchers identify cause of inherited metabolic disorder
April 18, 2019 - Single strip of white paint not sufficient to protect people who ride bikes
April 18, 2019 - Partner status influences link between sexual problems and self-efficacy in breast cancer survivors
April 18, 2019 - Colorectal Neoplasia Risk Up for Hodgkin Lymphoma Survivors
April 18, 2019 - Rigid spine muscular dystrophy – Genetics Home Reference
April 18, 2019 - Simple bile acid blood test could tell risk of stillbirth
April 18, 2019 - Center for Experimental Therapeutics aims to enable all steps of drug development | News Center
April 18, 2019 - Falling for telephone scams could be an early sign of dementia
April 18, 2019 - Researchers annotate key neuronal proteins in lamprey genome
April 18, 2019 - Study uncovers new biomarker for personalized cancer treatments
April 18, 2019 - Scientists enter research collaboration to find a cure for cancer
April 18, 2019 - Study to compare benefits of tai chi and mindfulness meditation on MS symptoms
April 18, 2019 - Gestational diabetes during pregnancy may increase risk of type 1 diabetes in children
April 18, 2019 - Is a New Remedy for Body Odor on the Horizon?
April 18, 2019 - Orthostatic hypotension – Genetics Home Reference
April 18, 2019 - Healing the heartbreak of stillbirth and newborn death
April 18, 2019 - Conference to highlight advances in human immune monitoring, bioinformatics | News Center
April 18, 2019 - Bacteria use viruses for self-recognition, study reveals
April 18, 2019 - New adhesive patch could help reduce post-heart attack muscle damage
April 18, 2019 - Researchers analyze the effects of dark play in a serious video game
April 18, 2019 - Filial cannibalism and offspring abandonment may be forms of parental care
April 18, 2019 - Two proteins act in concert to maintain a healthy heart in mice, shows study
April 18, 2019 - Scientists create a functioning 3D printed heart
April 18, 2019 - Non-invasive vagus nerve stimulation improves disease symptoms in patients with rheumatoid arthritis
April 18, 2019 - Majority of men struggle to understand diagnosis and treatment of prostate cancer
April 18, 2019 - Researchers create new small molecules that may combat equine encephalitis viruses
April 18, 2019 - Animal-assisted therapy improves social behavior in patients with brain injuries
April 18, 2019 - Some viruses help protect harmful bacteria in CF patients | News Center
April 18, 2019 - Outpatient healthcare providers inappropriately prescribe antibiotics to 40% of patients
April 18, 2019 - Men who have a resting heart rate of 75 bpm are twice as likely to die early
April 18, 2019 - Novel serum biomarkers to detect NAFLD-related fibrosis
April 18, 2019 - New study delves deeper into individual genomic differences than ever before
April 18, 2019 - Gilead and Galapagos Announce Filgotinib Meets Primary Endpoint in the Phase 3 FINCH 3 Study in Methotrexate-Naïve Rheumatoid Arthritis Patients
April 18, 2019 - Emotional mirror neurons found in rats
April 18, 2019 - Sylvia Plevritis appointed chair of biomedical data science | News Center
April 18, 2019 - Yeast strain provides manufacturing boost to low-calorie sweetener derived from lactose
April 18, 2019 - One in five children and youth suffer from a mental disorder
April 18, 2019 - Improper inhaler use common in children with asthma
April 18, 2019 - C-Path and CDISC release global Therapeutic Area Standard for HIV research
April 18, 2019 - Integrating AI to analyze imaging data allows early recognition of heart disease
April 18, 2019 - Low-cost, high-speed algorithm may allow animal-free chemical toxicity testing
April 18, 2019 - HPV-negative cervical cancers are more aggressive with worse prognosis
April 18, 2019 - AI detects prostate cancer with same level of accuracy as experienced radiologists
April 18, 2019 - Study resolves sex differences in psychiatric illness risk
April 18, 2019 - Novartis Announces FDA Filing Acceptance and Priority Review of Brolucizumab (RTH258) for Patients with Wet AMD
April 18, 2019 - Cocktail of common antibiotics can fight resistant E. coli
April 18, 2019 - Persis Drell to give keynote address at medical school diploma ceremony | News Center
April 18, 2019 - EpicTogether: Remembering Our Why
April 18, 2019 - Study identifies novel loci contributing to asthma susceptibility in adults
April 18, 2019 - Gut bacteria and pregnancy
April 18, 2019 - New study finds that screening could help prevent rare types of cervical cancer
April 17, 2019 - Spatial orgnization of the genome can be altered using small molecules
April 17, 2019 - AEDs Tied to Higher Pneumonia Risk in Alzheimer Patients
April 17, 2019 - Telemedicine tied to more antibiotics for kids, study finds
April 17, 2019 - Two medical students awarded 2019 Soros Fellowships for New Americans | News Center
April 17, 2019 - Sociologist Constance A. Nathanson Awarded Guggenheim Fellowship
April 17, 2019 - Empathy and hormones could account for aggressive behavior in children, shows study
April 17, 2019 - Researchers develop oral appliance to help sufferers of sleep apnea
April 17, 2019 - Neuronal transport factor detects its target transcripts in more complex manner than previously thought
April 17, 2019 - New drug-delivery system senses high oxidant levels, responds to body chemistry and environment
April 17, 2019 - Health Tip: Horseback Trail Riding Safety
April 17, 2019 - Scientists outline the promises and pitfalls of machine learning in medicine
April 17, 2019 - $12 million grant renewal for flu vaccine research | News Center
April 17, 2019 - Lisa Kachnic, MD, Joins Columbia University as Chair of Radiation Oncology
April 17, 2019 - New study sheds light on how extreme temperature hampers spermatogenesis in insects
April 17, 2019 - Study tests high-tech, non-pharmaceutical way to address ADHD and distractibility
April 17, 2019 - New EZ-2 evaporator for clinical biochemistry sample preparation
April 17, 2019 - Fat shaming celebrities may make women more judgemental about being overweight
April 17, 2019 - Magic mouthwash effectively reduces mouth sore pain caused by radiation therapy
April 17, 2019 - CBD could help slip medications into the brain
April 17, 2019 - Scientists characterize 2017 pneumonic plague outbreak in Madagascar
April 17, 2019 - Human iPSC-derived MSCs from aged individuals acquire a rejuvenation signature
April 17, 2019 - Gun Research Is Suddenly Hot
Cardiovascular benefits of diabetes drug extend across a wide spectrum of patients, shows study

Cardiovascular benefits of diabetes drug extend across a wide spectrum of patients, shows study

image_pdfDownload PDFimage_print

The cardiovascular benefits of the diabetes drug dapagliflozin extend across a wide spectrum of patients and are especially pronounced in those with reduced ejection fraction, a measure of the heart’s pumping ability indicative of poor heart functioning, according to research presented at the American College of Cardiology’s 68thAnnual Scientific Session.

The findings stem from the DECLARE-TIMI 58 trial, which reported in 2018 that dapagliflozin, part of a class of drugs known as SGLT2 inhibitors, reduced the composite primary endpoint of cardiovascular death and heart failure hospitalizations, which was mainly driven by the reduction in hospitalization for heart failure. The new analysis is the first to examine whether dapagliflozin’s benefits can be predicted based on left ventricular ejection fraction (LVEF), a measure of how effectively the heart’s left ventricle squeezes blood out of its chamber. Ejection fraction, typically evaluated using an ultrasound of the heart known as an echocardiogram, is a tool for objectively evaluating heart function and has been shown to predict how patients respond to other therapies.

Heart failure is a condition in which the heart cannot pump enough blood to meet the body’s needs. Low ejection fraction can be evidence of heart failure, though many patients have heart failure with normal, or preserved, ejection fraction. Researchers found dapagliflozin decreased heart failure hospitalizations across all patients, regardless of ejection fraction or whether or not they had heart failure at the start of the study. However, the drug significantly decreased rates of death from cardiovascular causes and death from all causes only among those who had a lower ejection fraction.

“The use of the SGLT2 inhibitor dapagliflozin is beneficial in reducing hospitalizations for heart failure in patients with a broad range of left ventricular ejection fraction, but patients with reduced ejection fraction may derive an even greater benefit,” said Eri T. Kato, MD, PhD, a cardiologist at Kyoto University Hospital and the study’s lead author. “The clinical implication of this finding is that ejection fraction is a strong tool to identify those who are at highest risk and may derive particular benefit from SGLT2 inhibitors.”

SGLT2 inhibitors improve the body’s ability to remove glucose from the bloodstream, helping to regulate blood sugar in people with diabetes. DECLARE-TIMI 58, conducted at 882 sites in 33 countries, enrolled more than 17,000 patients who had Type 2 diabetes, as well as either established cardiovascular disease or a high risk for cardiovascular disease. Patients were randomized to receive dapagliflozin or a placebo and followed for a median of just over four years.

Thirty percent of study participants (5,202 patients) had their LVEF documented at the start of the trial. Of these participants, 13 percent (671 patients) had heart failure with reduced ejection fraction (HFrEF), defined as an ejection fraction less than 45 percent, meaning that just 45 percent of the blood in the left ventricle is squeezed out with each heartbeat.

Researchers compared rates of heart failure hospitalizations, cardiovascular death and all-cause mortality among patients with HFrEF and those without HFrEF. They found patients with HFrEF who took dapagliflozin were 38 percent less likely to be hospitalized for heart failure or die of cardiovascular causes compared with those taking placebo, a significantly greater reduction than the 12 percent drop in the likelihood of these events among patients who did not have HFrEF.

Patients who had HFrEF also showed a significantly lower rate of cardiovascular death and death from any cause, rates of which dropped by 45 percent and 41 percent, respectively, among those taking dapagliflozin compared to those taking placebo. Researchers did not observe these benefits in patients without HFrEF. Taking dapagliflozin reduced the rate of heart failure hospitalizations among all patients, regardless of ejection fraction or heart failure status.

“The reduction in hospitalization for heart failure is remarkable because there have been very few therapies that have shown any benefit both in patients with heart failure with preserved ejection fraction and in patients with heart failure with reduced ejection fraction,” Kato said. “Furthermore, there appears to be a benefit for heart failure reduction across a broad spectrum of patients with and without heart failure, suggesting that use of these agents could be beneficial in a very large population of patients with diabetes.”

Patients who have heart failure with reduced ejection fraction generally face a higher risk for cardiovascular events and death compared to those with normal ejection fraction. In the trial, these patients also showed a benefit from dapagliflozin in terms of heart failure hospitalizations earlier than the other groups, while the benefits took a year or more to appear in other groups. Noting that the interplay between diabetes and heart failure is complex and multifactorial, Kato said further studies are needed to understand the mechanisms driving these differences.

Researchers plan to further analyze the DECLARE-TIMI 58 data to understand dapagliflozin’s effects on metabolic, renal and cardiovascular outcomes. Other ongoing trials are investigating SGLT2 inhibitors in patients with heart failure, which should shed further light on the benefits observed in this study, Kato said.

Tagged with:

About author

Related Articles