PHILADELPHIA — Giving the SGLT-2 inhibitor dapagliflozin (Farxiga) to patients with acute myocardial infarction (MI) and impaired left ventricular systolic function but no diabetes or chronic heart failure significantly improved a composite of cardiovascular outcomes, a European registry-based randomized trial suggests.
Dr Stefan James presenting at AHA23 in Philadelphia
In presenting these results from the DAPA-MI trial, Stefan James, MD, of Uppsala University in Sweden, noted that patients randomly assigned to dapagliflozin 10 mg along with the standard of care had improved outcomes based on a composite of seven primary endpoints, which the trial described as the hierarchical "win ratio" composite outcomes, compared with patients randomized to placebo plus standard of care.
"The 'win ratio' tells us that there's a 34% higher likelihood of patients having a better cardiometabolic outcome with dapagliflozin vs placebo in terms of the seven components," James said in an interview. The win ratio was achieved in 32.9% of dapagliflozin patients vs 24.6% of placebo (P < .001).
James presented the results here today at the American Heart Association Scientific Sessions 2023, and they were published online simultaneously in NEJM Evidence.
Lower-Risk Patients
DAPA-MI enrolled 4017 patients from the SWEDEHEART and Myocardial Ischemia National Audit Project registries in Sweden and the United Kingdom, randomly assigning patients to dapagliflozin 10 mg or placebo along with guideline-directed therapy for both groups.
