The following article is a part of conference coverage from the American Heart Association Scientific Sessions 2021, being held virtually from November 13 to 15, 2021. The team at Cardiology Advisor will be reporting on the latest news and research conducted by leading experts in cardiology. Check back for more from the AHA Scientific Sessions 2021.

Treatment with dapagliflozin significantly improves blood pressure (BP), weight, hemoglobin A1c (HbA1c), hemoglobin (Hb), and hematocrit (Hct) but has no statistically significant effect on left ventricular (LV) remodeling in patients with type 2 diabetes (T2D), according to study results presented at the American Heart Association Scientific Sessions 2021, held from November 13 to 15, 2021.

In a meta-analysis of phase IV randomized controlled trials (RCTs) that evaluated dapagliflozin vs placebo, researchers sought to prove their hypothesis that dapagliflozin can reverse LV remodeling in patients with type 2 diabetes. From these studies, researchers extracted the mean difference (MD) of multiple parameters and the 95% CI to compute pooled MD using RevMan v.5.3. In the case of significant heterogeneity (>40%, as assessed by I-squared), a random effects model was employed.


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Two of the RCTs were finalized (N=122; dapagliflozin [n=60] and placebo [n=62]); patients (men=75 and women=47) were all aged 60 years and over and had T2D. In pooled analysis, there was no significant difference in LV remodeling with dapagliflozin compared with placebo (LV mass index reduction (g/m2): MD -0.14; 95% CI, -1.12 to 0.85; P =.78; I2=0%), ejection fraction (MD 0.77; 95% CI, -0.97 to 2.51; P =.87; I2=0%), LV end-systolic volume (MD -1.02; 95% CI, -3.38 to 1.34; P =.40; I2=0%), stroke volume (MD 1.19; 95% CI, -1.66 to 4.04; P =.41; I2=0%), and heart rate (MD -2.15; 95% CI, -5.14 to 0.85; P =.16; I2=0%).

Dapagliflozin reduced both systolic (MD -3.66; 95% CI, -7.29 to -0.02; P =.05; I2=0%) and diastolic BP (MD -3.04; 95% CI, -5.75 to -0.32; P =.03; I2=84%). In the dapaglifozin group, patients’ weight was reduced by up to 3.4 kg (MD -3.42; 95% CI, -4.48 to -2.36; P <0.05; I2=59%), and HbA1c was up to 3.7% (MD -3.76; 95% CI, -7.35 to -0.17; P =.04; I2=14%). Treatment with dapagliflozin also improved Hb (MD 1.08; 95% CI, 0.50-1.66; P <0.05; I2=95%) and Hct (MD 2.90; 95% CI, 1.99-3.80; P <.05; I2=0%).

Based on this meta-analysis, researchers suggested that treating patients with T2D with dapagliflozin can result in significant improvements in BP, weight, HbA1c, Hb, and Hct, without any significant effect on LV remodeling compared with placebo.

Reference

Bilal H, Saleem N, Farooqui A, Uddin S, Maheshwari S, Hollander G. Dapagliflozin does not affect left ventricular remodeling in patients with type 2 diabetes: a meta-analysis of phase IV randomized controlled trials. Presented at: AHA 2021; November 13-15, 2021. Poster P1623.

 

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