2024
Effect of dapagliflozin in patients with diabetes and heart failure with mildly reduced or preserved ejection fraction according to background glucose‐lowering therapy: A pre‐specified analysis of the DELIVER trial
Lassen M, Ostrominski J, Inzucchi S, Claggett B, Kulac I, Jhund P, de Boer R, Hernandez A, Kosiborod M, Lam C, Martinez F, Shah S, Desai A, Petersson M, Langkilde A, Docherty K, McMurray J, Solomon S, Vaduganathan M. Effect of dapagliflozin in patients with diabetes and heart failure with mildly reduced or preserved ejection fraction according to background glucose‐lowering therapy: A pre‐specified analysis of the DELIVER trial. European Journal Of Heart Failure 2024, 26: 1539-1548. PMID: 38745498, DOI: 10.1002/ejhf.3269.Peer-Reviewed Original ResearchConceptsBackground glucose-lowering therapyLeft ventricular ejection fractionGlucose-lowering therapySodium-glucose cotransporter 2 inhibitorsHeart failureClinical outcomesComposite of worsening HFPrimary outcomeInsulin useBenefits of dapagliflozinVentricular ejection fractionEffects of dapagliflozinType 2 diabetesEjection fractionRandomized patientsMetformin useConcomitant metforminCardiovascular deathFollow-upContemporary guidelinesDapagliflozinTreatment effectsDELIVER trialTreatment benefitT2DDapagliflozin and quality of life measured using the EuroQol 5‐dimension questionnaire in patients with heart failure with reduced and mildly reduced/preserved ejection fraction
Yang M, Kondo T, Talebi A, Jhund P, Docherty K, Claggett B, Vaduganathan M, Bachus E, Hernandez A, Lam C, Inzucchi S, Martinez F, de Boer R, Kosiborod M, Desai A, Køber L, Ponikowski P, Sabatine M, Solomon S, McMurray J. Dapagliflozin and quality of life measured using the EuroQol 5‐dimension questionnaire in patients with heart failure with reduced and mildly reduced/preserved ejection fraction. European Journal Of Heart Failure 2024, 26: 1524-1538. PMID: 38700986, DOI: 10.1002/ejhf.3263.Peer-Reviewed Original ResearchConceptsVisual analogue scaleEjection fractionEQ-5D-5L visual analogue scaleHealth-related quality of lifeIndex scorePatient-level pooled analysisComposite of cardiovascular deathQuality of lifeSafety of dapagliflozinEffects of dapagliflozinReduced ejection fractionAssociated with better outcomesPrevalence of comorbiditiesEuroQol 5-dimension questionnaireMeasures of health-related quality of lifePatient self-reportDAPA-HFWorsening HFVAS scoreClinical characteristicsAtrial fibrillationComposite outcomeHeart failurePooled analysisAnalogue scaleSex Differences in Heart Failure With Improved Ejection Fraction The DELIVER Trial
Pabón M, Wang X, Lam C, O'Meara E, Vaduganathan M, Claggett B, Foà A, Lu H, Langkilde A, De Boer R, Desai A, Hernandez A, Inzucchi S, Jhund P, Kosiborod M, Martinez F, Shah S, Petersson M, McMurray J, Solomon S, Vardeny O. Sex Differences in Heart Failure With Improved Ejection Fraction The DELIVER Trial. JACC Heart Failure 2024, 12: 1119-1122. PMID: 38661586, DOI: 10.1016/j.jchf.2024.03.011.Peer-Reviewed Original ResearchDapagliflozin and Timing of Prior Heart Failure Hospitalization A Patient-Level Meta-Analysis of DAPA-HF and DELIVER
Butt J, Jhund P, Docherty K, Claggett B, Vaduganathan M, Bachus E, Hernandez A, Lam C, Inzucchi S, Martinez F, de Boer R, Kosiborod M, Desai A, Køber L, Ponikowski P, Sabatine M, Solomon S, McMurray J. Dapagliflozin and Timing of Prior Heart Failure Hospitalization A Patient-Level Meta-Analysis of DAPA-HF and DELIVER. JACC Heart Failure 2024, 12: 1586-1599. PMID: 38573262, DOI: 10.1016/j.jchf.2024.01.018.Peer-Reviewed Original ResearchConceptsHF hospitalizationDAPA-HFHeart failureComposite of worsening HFPrimary outcomePatient-level pooled analysisRisk of adverse clinical outcomesBenefits of dapagliflozinMedian follow-upMonths of randomizationEffects of dapagliflozinAdverse clinical outcomesPrior HF hospitalizationHospital categoryPrimary endpointPrevent 1 eventClinical outcomesAbsolute benefitEffective therapyFollow-upCardiovascular deathDapagliflozinAssociated with timeHigh riskPatientsDapagliflozin and Days of Full Health Lost in the DAPA-HF Trial
Kondo T, Mogensen U, Talebi A, Gasparyan S, Campbell R, Docherty K, de Boer R, Inzucchi S, Køber L, Kosiborod M, Martinez F, Sabatine M, Bengtsson O, Sjöstrand M, Vaduganathan M, Solomon S, Jhund P, McMurray J. Dapagliflozin and Days of Full Health Lost in the DAPA-HF Trial. Journal Of The American College Of Cardiology 2024, 83: 1973-1986. PMID: 38537918, DOI: 10.1016/j.jacc.2024.03.385.Peer-Reviewed Original ResearchConceptsDAPA-HFLeft ventricular ejection fractionNYHA functional class IIEfficacy of dapagliflozinFunctional class IIIV heart failureVentricular ejection fractionEffects of dapagliflozinHeart failure hospitalizationDAPA-HF trialWell-beingFollow-up daysBetween-treatment differencesDapagliflozin groupPlacebo groupTime-to-first-event analysisEjection fractionFailure hospitalizationPatient well-beingHeart failureCardiovascular deathDapagliflozinRecurrent hospitalizationsClass IIPlaceboDapagliflozin in patients with heart failure and previous myocardial infarction: A participant‐level pooled analysis of DAPA‐HF and DELIVER
Peikert A, Vaduganathan M, Claggett B, Kulac I, Foà A, Desai A, Jhund P, Carberry J, Lam C, Kosiborod M, Inzucchi S, Martinez F, de Boer R, Hernandez A, Shah S, Køber L, Ponikowski P, Sabatine M, Petersson M, Langkilde A, McMurray J, Solomon S. Dapagliflozin in patients with heart failure and previous myocardial infarction: A participant‐level pooled analysis of DAPA‐HF and DELIVER. European Journal Of Heart Failure 2024, 26: 912-924. PMID: 38487939, DOI: 10.1002/ejhf.3184.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionHeart failureHistory of MIMyocardial infarctionPrimary outcomeDAPA-HFWorsening HFSpectrum of left ventricular ejection fractionLeft ventricular ejection fraction spectrumCardiovascular deathSodium-glucose cotransporter 2 inhibitorsRisk of disease progressionComposite of cardiovascular deathRisk of adverse cardiovascular outcomesIncreased risk of adverse cardiovascular outcomesRisk of cardiovascular deathVentricular ejection fractionHistory of myocardial infarctionSerious adverse eventsAdverse cardiovascular outcomesSymptomatic HFEjection fractionAdverse eventsCovariate-adjusted modelsPooled analysisDapagliflozin and Mode of Death in Heart Failure With Improved Ejection Fraction
Vardeny O, Desai A, Jhund P, Fang J, Claggett B, de Boer R, Hernandez A, Inzucchi S, Kosiborod M, Lam C, Martinez F, Shah S, Mc Causland F, Petrie M, Vaduganathan M, McMurray J, Solomon S. Dapagliflozin and Mode of Death in Heart Failure With Improved Ejection Fraction. JAMA Cardiology 2024, 9: 283-289. PMID: 38265835, PMCID: PMC10809142, DOI: 10.1001/jamacardio.2023.5318.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionMode of deathEjection fractionCause-specific deathHeart failureCardiovascular deathNew York Heart Association class IIGuideline-directed medical therapyStudy case report formsSudden deathVentricular ejection fractionRate of sudden deathAssociated with lower ratesCox regression modelsImproved ejection fractionRandomized clinical trialsReduce cardiovascular mortalityCase report formsEnd-point committeeClinical end point committeePost hoc analysisDapagliflozin EvaluationIV symptomsHFimpEFMedical therapy
2023
Heart Failure, Investigator-Reported Sleep Apnea and Dapagliflozin: A Patient-Level Pooled Meta-Analysis of DAPA-HF and DELIVER
Butt J, Jering K, DE Boer R, Claggett B, Desai A, Hernandez A, Inzucchi S, Jhund P, Køber L, Kosiborod M, Lam C, Martinez F, Ponikowski P, Sabatine M, Shah S, Vaduganathan M, Langkilde A, Bengtsson O, Petersson M, Sjöstrand M, Wilderäng U, Solomon S, McMurray J. Heart Failure, Investigator-Reported Sleep Apnea and Dapagliflozin: A Patient-Level Pooled Meta-Analysis of DAPA-HF and DELIVER. Journal Of Cardiac Failure 2023, 30: 436-448. PMID: 38104937, DOI: 10.1016/j.cardfail.2023.08.027.Peer-Reviewed Original ResearchConceptsHistory of sleep apneaPrevalence of sleep apneaEffects of dapagliflozinSleep apneaWorsening HF eventsDAPA-HFAssociated with higher ratesHeart failureClinical outcomesEjection fractionPooled analysisComposite of worsening HFEffects of HF therapiesPrimary outcomeHF eventsDELIVER trialBenefits of dapagliflozinDAPA-HF trialAssociated with outcomePrimary endpointHF therapyHigher ratesHF phenotypesApneaTreatment optionsEfficacy of Dapagliflozin According to Heart Rate: A Patient-Level Pooled Analysis of DAPA-HF and DELIVER
Kondo T, Butt J, Curtain J, Jhund P, Docherty K, Claggett B, Vaduganathan M, Bachus E, Hernandez A, Lam C, Inzucchi S, Martinez F, de Boer R, Kosiborod M, Desai A, Køber L, Ponikowski P, Sabatine M, Solomon S, McMurray J. Efficacy of Dapagliflozin According to Heart Rate: A Patient-Level Pooled Analysis of DAPA-HF and DELIVER. Circulation Heart Failure 2023, 16: e010898. PMID: 37886880, DOI: 10.1161/circheartfailure.123.010898.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionReduced ejection fractionVentricular ejection fractionPatient-level pooled analysisBenefit of dapagliflozinEjection fractionHeart failureAtrial fibrillationBaseline heart rateSinus rhythmHeart ratePrimary outcomeDAPA-HFCardiovascular deathPooled analysisHR rangeEfficacy of dapagliflozinEffect of dapagliflozinHeart failure phenotypeHigher heart rateCardiovascular eventsHazard ratioHigh riskFailure phenotypePatientsDapagliflozin and Apparent Treatment-Resistant Hypertension in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: The DELIVER Trial
Ostrominski J, Vaduganathan M, Selvaraj S, Claggett B, Miao Z, Desai A, Jhund P, Kosiborod M, Lam C, Inzucchi S, Martinez F, de Boer R, Hernandez A, Shah S, Petersson M, Langkilde A, McMurray J, Solomon S. Dapagliflozin and Apparent Treatment-Resistant Hypertension in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: The DELIVER Trial. Circulation 2023, 148: 1945-1957. PMID: 37830208, DOI: 10.1161/circulationaha.123.065254.Peer-Reviewed Original ResearchMeSH KeywordsBenzhydryl CompoundsHeart FailureHumansHypertensionStroke VolumeVentricular Function, LeftConceptsApparent treatment-resistant hypertensionBaseline blood pressureTreatment-resistant hypertensionVentricular ejection fractionEjection fractionNonresistant hypertensionPrimary outcomeHeart failureBP categoriesHigher left ventricular ejection fractionSystolic baseline blood pressureLeft ventricular ejection fractionRelative treatment benefitSerious adverse eventsKey secondary outcomesRisk of hypotensionWorse kidney functionHigh-risk populationProportion of participantsBaseline BP categoriesGreater absolute reductionCardiometabolic comorbiditiesHypertension groupVascular eventsAdverse eventsHeart failure, chronic obstructive pulmonary disease and efficacy and safety of dapagliflozin in heart failure with mildly reduced or preserved ejection fraction: Insights from DELIVER
Butt J, Lu H, Kondo T, Bachus E, de Boer R, Inzucchi S, Jhund P, Kosiborod M, Lam C, Martinez F, Vaduganathan M, Solomon S, McMurray J. Heart failure, chronic obstructive pulmonary disease and efficacy and safety of dapagliflozin in heart failure with mildly reduced or preserved ejection fraction: Insights from DELIVER. European Journal Of Heart Failure 2023, 25: 2078-2090. PMID: 37634087, DOI: 10.1002/ejhf.3000.Peer-Reviewed Original ResearchMeSH KeywordsBenzhydryl CompoundsHeart FailureHumansPulmonary Disease, Chronic ObstructiveStroke VolumeVentricular Function, LeftConceptsChronic obstructive pulmonary diseaseModerate chronic obstructive pulmonary diseaseCOPD statusSafety of dapagliflozinObstructive pulmonary diseaseHeart failurePulmonary diseasePrimary outcomeEjection fractionWorse outcomesKansas City Cardiomyopathy Questionnaire scoreBenefit of dapagliflozinPre-specified analysisSevere pulmonary diseaseCardiovascular deathCause hospitalizationPrimary endpointTreatment discontinuationAdverse eventsClinical eventsQuestionnaire scoresPlaceboDapagliflozinPatientsKnown historyOutpatient Worsening Among Patients With Mildly Reduced and Preserved Ejection Fraction Heart Failure in the DELIVER Trial
Chatur S, Vaduganathan M, Claggett B, Cunningham J, Docherty K, Desai A, Jhund P, de Boer R, Hernandez A, Inzucchi S, Kosiborod M, Lam C, Martinez F, Shah S, Petersson M, Langkilde A, McMurray J, Solomon S. Outpatient Worsening Among Patients With Mildly Reduced and Preserved Ejection Fraction Heart Failure in the DELIVER Trial. Circulation 2023, 148: 1735-1745. PMID: 37632455, PMCID: PMC10664793, DOI: 10.1161/circulationaha.123.066506.Peer-Reviewed Original ResearchConceptsUrgent HF visitsComposite end pointHeart failureHF hospitalizationHF visitsHF eventsFirst presentationCardiovascular deathEnd pointEjection fractionSubsequent mortalitySubsequent deathEjection fraction heart failurePrimary end pointCardiovascular causesClinical decompensationPrespecified analysisAmbulatory carePatientsClinical relevanceSentinel eventsHospitalizationDapagliflozinDeathVisitsDapagliflozin in Patients With Heart Failure and Deterioration in Renal Function
Chatur S, Vaduganathan M, Claggett B, Mc Causland F, Desai A, Jhund P, de Boer R, Hernandez A, Inzucchi S, Kosiborod M, Lam C, Martinez F, Shah S, Sabatine M, Kober L, Ponikowski P, Merkely B, Petersson M, Langkilde A, McMurray J, Solomon S. Dapagliflozin in Patients With Heart Failure and Deterioration in Renal Function. Journal Of The American College Of Cardiology 2023, 82: 1854-1863. PMID: 37634707, DOI: 10.1016/j.jacc.2023.08.026.Peer-Reviewed Original ResearchMeSH KeywordsBenzhydryl CompoundsChronic DiseaseDiabetes Mellitus, Type 2Heart FailureHumansKidneyStroke VolumeConceptsDeterioration of eGFRHeart failureSafety outcomesKidney functionTreatment groupsTime-updated Cox proportional hazards modelsSodium-glucose cotransporter 2 inhibitorsComorbid chronic kidney diseaseCox proportional hazards modelPrimary composite outcomeChronic kidney diseaseCotransporter 2 inhibitorsEffect of dapagliflozinGlomerular filtration rateProportional hazards modelLives of patientsDAPA-HFDrug discontinuationCardiovascular deathCardiovascular outcomesStudy drugChronic heartComposite outcomeDapagliflozin treatmentPrimary outcomeEfficacy of Dapagliflozin According to Geographic Location of Patients With Heart Failure
Kondo T, Wang X, Yang M, Jhund P, Claggett B, Vaduganathan M, Hernandez A, Lam C, Inzucchi S, Martinez F, de Boer R, Kosiborod M, Desai A, Køber L, Ponikowski P, Sabatine M, Langkilde A, Petersson M, Zaozerska N, Bachus E, Solomon S, McMurray J. Efficacy of Dapagliflozin According to Geographic Location of Patients With Heart Failure. Journal Of The American College Of Cardiology 2023, 82: 1014-1026. PMID: 37610398, DOI: 10.1016/j.jacc.2023.05.056.Peer-Reviewed Original ResearchConceptsSafety of dapagliflozinHeart failurePrimary outcomeEjection fractionPatient-level pooled analysisBenefit of dapagliflozinEfficacy of dapagliflozinReduced ejection fractionEffect of dapagliflozinDAPA-HFCardiovascular deathClinical characteristicsDiscontinuation ratesPatient characteristicsPooled analysisDapagliflozinPatientsBackground treatmentEvent ratesInhibitor efficacyEfficacyGeographic regionsOutcomesTreatmentPrevious reportsDapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction
Butt J, Docherty K, Kosiborod M, Inzucchi S, Køber L, Langkilde A, Martinez F, Bengtsson O, Ponikowski P, Sabatine M, Sjöstrand M, Solomon S, Jhund P, McMurray J. Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction. JACC Heart Failure 2023, 11: 1411-1423. PMID: 37318419, DOI: 10.1016/j.jchf.2023.04.016.Peer-Reviewed Original ResearchConceptsKansas City Cardiomyopathy QuestionnaireActivity limitation scoresEffect of dapagliflozinLimitation scoresSocial activity limitationsHeart failureActivity limitationsDAPA-HF trialReduced ejection fractionProportion of patientsActivity limitation domainLimitation domainEjection fractionPhysical functionChronic diseasesDapagliflozinPatientsHealth statusPlaceboMixed-effects modelsMonthsBaselineComplete dataScoresSocial limitationsDapagliflozin and Kidney Outcomes in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction
Mc Causland F, Claggett B, Vaduganathan M, Desai A, Jhund P, de Boer R, Docherty K, Fang J, Hernandez A, Inzucchi S, Kosiborod M, Lam C, Martinez F, Saraiva J, McGrath M, Shah S, Verma S, Langkilde A, Petersson M, McMurray J, Solomon S. Dapagliflozin and Kidney Outcomes in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction. JAMA Cardiology 2023, 8: 56-65. PMID: 36326604, PMCID: PMC9634592, DOI: 10.1001/jamacardio.2022.4210.Peer-Reviewed Original ResearchConceptsBaseline kidney functionKidney composite outcomeEffect of dapagliflozinEjection fractionHeart failureKidney outcomesComposite outcomePrimary outcomeKidney functionKidney diseaseSodium-glucose cotransporter 2 inhibitorsBaseline eGFR categoryBaseline kidney diseaseBenefit of dapagliflozinComposite kidney outcomeHeart Failure TrialReduced ejection fractionCotransporter 2 inhibitorsHeart failure eventsGlomerular filtration rateOverall incidence rateOverall event rateLives of patientsTreatment effectsEGFR categories
2022
IGFBP-7 and Outcomes in Heart Failure With Reduced Ejection Fraction Findings From DAPA-HF
Adamson C, Welsh P, Docherty K, de Boer R, Diez M, Drożdż J, Dukát A, Inzucchi S, Køber L, Kosiborod M, Ljungman C, Martinez F, Ponikowski P, Sabatine M, Morrow D, Lindholm D, Hammarstedt A, Boulton D, Greasley P, Langkilde A, Solomon S, Sattar N, McMurray J, Jhund P. IGFBP-7 and Outcomes in Heart Failure With Reduced Ejection Fraction Findings From DAPA-HF. JACC Heart Failure 2022, 11: 291-304. PMID: 36592046, DOI: 10.1016/j.jchf.2022.09.004.Peer-Reviewed Original ResearchConceptsInsulin-like growth factor-binding protein 7IGFBP-7 levelsHeart failureN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideHigh-sensitivity troponin TCox proportional hazards modelBenefit of dapagliflozinDAPA-HF trialEjection fraction (EF) findingsIGFBP-7 concentrationsWorse clinical profileReduced ejection fractionAdverse clinical outcomesPotential prognostic biomarkerProportional hazards modelAdvanced HFrEFDAPA-HFCardiovascular deathHF outcomesNT-proBNPPrimary endpointClinical profileEjection fractionHighest tertileDapagliflozin in patients with heart failure with mildly reduced and preserved ejection fraction treated with a mineralocorticoid receptor antagonist or sacubitril/valsartan
Yang M, Butt J, Kondo T, Jering K, Docherty K, Jhund P, de Boer R, Claggett B, Desai A, Hernandez A, Inzucchi S, Kosiborod M, Lam C, Langkilde A, Martinez F, Petersson M, Shah S, Vaduganathan M, Wilderäng U, Solomon S, McMurray J. Dapagliflozin in patients with heart failure with mildly reduced and preserved ejection fraction treated with a mineralocorticoid receptor antagonist or sacubitril/valsartan. European Journal Of Heart Failure 2022, 24: 2307-2319. PMID: 36342375, PMCID: PMC11497302, DOI: 10.1002/ejhf.2722.Peer-Reviewed Original ResearchConceptsAngiotensin receptor neprilysin inhibitorMineralocorticoid receptor antagonistsSafety of dapagliflozinHeart failureEjection fractionPrimary outcomeReceptor antagonistRecent guidelinesSodium-glucose cotransporter 2 inhibitorsLower systolic blood pressureBenefit of dapagliflozinPrior HF hospitalizationSacubitril/valsartanCotransporter 2 inhibitorsEffect of dapagliflozinSystolic blood pressureARNI therapyHF hospitalizationCardiovascular deathAdverse eventsHazard ratioBlood pressureSGLT2 inhibitorsPatientsDapagliflozinBlood Pressure and Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction DELIVER
Selvaraj S, Vaduganathan M, Claggett B, Miao Z, Fang J, Vardeny O, Desai A, Shah S, Lam C, Martinez F, Inzucchi S, de Boer R, Petersson M, Langkilde A, McMurray J, Solomon S. Blood Pressure and Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction DELIVER. JACC Heart Failure 2022, 11: 76-89. PMID: 36599553, DOI: 10.1016/j.jchf.2022.09.002.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBenzhydryl CompoundsBlood PressureFemaleHeart FailureHumansMaleMiddle AgedStroke VolumeConceptsSystolic blood pressureBlood pressureHeart failureSBP categoriesEjection fractionPrimary outcomeKansas City Cardiomyopathy Questionnaire total symptom scoreTreatment effectsSodium-glucose cotransporter 2 inhibitorsBaseline systolic blood pressureBlood pressure-lowering effectHigher systolic blood pressureHigher heart failureClass I recommendationCotransporter 2 inhibitorsPressure-lowering effectTotal symptom scoreCardiovascular outcomesAdverse eventsAntihypertensive effectSecondary outcomesStroke riskI recommendationSymptom scoresCardiovascular diseaseInfluence of NT-proBNP on Efficacy of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction
Myhre P, Vaduganathan M, Claggett B, Miao Z, Jhund P, de Boer R, Hernandez A, Inzucchi S, Kosiborod M, Lam C, Martinez F, Shah S, Desai A, Lindholm D, Petersson M, Langkilde A, McMurray J, Solomon S. Influence of NT-proBNP on Efficacy of Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction. JACC Heart Failure 2022, 10: 902-913. PMID: 36114137, DOI: 10.1016/j.jchf.2022.08.007.Peer-Reviewed Original ResearchConceptsNT-proBNP concentrationsBaseline NT-proBNP concentrationHigher NT-proBNP concentrationsNT-proBNP levelsNT-proBNPHeart failureEjection fractionN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideBaseline NT-proBNP levelsHigher NT-proBNP levelsBaseline NT-proBNPEfficacy of dapagliflozinElevated NT-proBNPMedian baseline concentrationNT-proBNP quartilesSafety of dapagliflozinPlacebo-controlled trialPrimary composite outcomeAbsolute risk reductionPrevious clinical trialsGreater absolute benefitCardiovascular deathComposite outcomePrimary outcome