Dapagliflozin Reduces Heart Failure Risk After TAVI: Key Findings from the DapaTAVI Trial - Video

Dapagliflozin significantly reduced the risk of all-cause mortality or worsening heart failure by 28% in high-risk patients undergoing transcatheter aortic valve implantation (TAVI).

This study has been published in the recent issue of New England Journal of Medicine.

The DapaTAVI trial, a multicenter randomized controlled study, enrolled 1257 patients, across 39 centers in Spain with mean age of 82.4 years with severe aortic stenosis and prior heart failure. The trial evaluated dapagliflozin 10 mg once daily versus standard care, initiated at or within 14 days after hospital discharge in patients undergoing TAVI.

Some of the key results from the study are:

1) At one year, dapagliflozin reduced the risk of death or worsening heart failure by 28% compared to standard care (15.0% vs 20.1%; HR 0.72; P = 0.02).

2) Dapagliflozin reduced worsening heart failure by 37%, hospitalizations by 32%, and urgent heart failure visits requiring IV diuretics by 54% compared to standard care.

3) Dapagliflozin reduced the risk of cardiovascular death or heart failure hospitalization by 29% and lowered total recurrent events, including cardiovascular deaths and hospitalizations, by 33% compared to standard care.

A subgroup analysis assessed the consistency of dapagliflozin’s effect across patient groups with some key highlights:

Patients with CV Risk Factors, Cardiac and Kidney comorbidities

Dapagliflozin reduced the risk of worsening heart failure or cardiovascular death in type 2 diabetes patients by 37% and hypertension patients by 27%. Among cardiac comorbidities primary outcome reduced by 37% in patients with atrial fibrillation, 29% in patients with moderate to severe LVH. The benefit was consistent in CKD patients with eGFR <60 ml/min/1.73 m², with the primary outcome reduction of 28%.

These findings concluded that Dapagliflozin reduced all- cause death and HF worsening within 14 days of initiation in high risk TAVI patients with aortic stenosis.