Safety and efficacy of dapagliflozin in individuals diagnosed with acute heart failure

A recent study demonstrated that the early administration of dapagliflozin during the acute heart failure (AHF) hospitalization is safe and serves as a component of guideline-directed medical therapy (GDMT) optimization. Additionally, dapagliflozin may be associated with improved diuresis in patients with AHF. This study's findings were published in the Journal of the American College of Cardiology.

A total of 240 patients were enrolled in this multicenter trial, where they were randomized to receive either dapagliflozin 10 mg once daily or structured usual care with protocolized diuretic titration within a period of 24 hours of hospital admission for hypervolemic AHF. The primary outcome of the study, diuretic efficiency, was assessed by comparing the cumulative weight change per cumulative loop diuretic dose between the two treatment groups.

Administration of dapagliflozin resulted in a reduction in loop diuretic doses (560 mg [Q1-Q3: 260-1,150 mg] compared to 800 mg [Q1-Q3: 380-1,715 mg]) and a reduced need for intravenous diuretic adjustments to achieve comparable weight loss as standard treatment. Commencing dapagliflozin early did not elevate the occurrence of safety issues related to diabetes, kidney function, or cardiovascular health. Additionally, dapagliflozin was linked to an enhancement in median 24-hour natriuresis and urine output, facilitating quicker hospital discharge throughout the study duration.

Thus, it can be concluded that the early use of dapagliflozin during AHF hospitalization is considered safe and fulfills a component of optimizing GDMT. Additionally, dapagliflozin may lead to improved diuresis in individuals with AHF.