Dapagliflozin vs empagliflozin in patients with chronic heart failure: a registry analysis.

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Croatian Medical Journal Pub Date : 2025-05-07
Ivana Jurin, Irzal Hadžibegović, Hrvoje Jurin, Diana Rudan, Nikola Pavlović, Marija Radić, Šime Manola, Vladimir Trkulja
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Abstract

Aim: To assess the relative efficacy of dapagliflozin and empagliflozin in routinely treated chronic heart failure (CHF) patients.

Methods: Data from a registry of prevalent and incident CHF patients were used to set up cohorts (new-user design) of patients started on dapagliflozin or empagliflozin in addition to other guideline-directed therapy. Cohorts were mutually balanced on a range of characteristics, and were assessed for the incidence of a composite of all-cause death/major adverse cardiac events (primary outcome) over the initial 6 months of treatment, and for New York Heart Association (NYHA) functional class at 6 months (secondary outcome). Frequentist and Bayes estimates were generated for the dapagliflozin vs empagliflozin comparison.

Results: In both prevalent (dapagliflozin n=393, empagliflozin n=328) and incident (dapagliflozin n=124, empagliflozin n=116) patients, those prescribed dapagliflozin had somewhat higher incidence of the primary outcome, but the confidence intervals were wide (RR=1.385, 95%CI 0.882-2.173 [prevalent], RR=2.192, 95%CI 0.765-6.282 [incident]), and were more likely to present with a worse NYHA class at 6 months (OR=1.552, 95%CI 1.142-2.108 [prevalent], OR=1.503, 95%CI 0.844-2.676 [incident]). In the pooled data, primary events (n=102) were more common in dapagliflozin-prescribed patients (frequentist estimate RR=1.519, 95%CI 1.239-1.861; Bayes RR=1.380, 95%CrI 0.981-1.944). Dapagliflozin-prescribed patients were also more likely to have a worse NYHA class at 6 months (OR=1.540, 95%CI 1.208-1.962; Bayes OR=1.425, 95%CrI 1.098-1.781).

Conclusion: CHF patients prescribed with dapagliflozin had poorer outcomes than their empagliflozin-prescribed peers over the initial 6 months of treatment. Data emphasize a need for a direct randomized comparison of the two treatments in this setting.

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慢性心力衰竭患者的达格列净vs恩格列净:注册分析
目的:评价达格列净与恩格列净在常规治疗慢性心力衰竭(CHF)患者中的相对疗效。方法:使用来自流行和事件CHF患者注册表的数据建立队列(新用户设计),这些患者开始使用达格列净或恩格列净以及其他指南指导的治疗。队列在一系列特征上相互平衡,并评估治疗最初6个月的全因死亡/主要心脏不良事件(主要结局)的复合发生率,以及6个月时纽约心脏协会(NYHA)功能分级(次要结局)。对dapagliflozin和empagliflozin的比较进行了频率估计和贝叶斯估计。结果:在流行(dapagliflozin n=393, empagliflozin n=328)和意外(dapagliflozin n=124, empagliflozin n=116)患者中,处方dapagliflozin的主要结局发生率略高,但置信区间较宽(RR=1.385, 95%CI 0.882-2.173[流行],RR=2.192, 95%CI 0.765-6.282[事件]),并且更有可能在6个月时出现较差的NYHA分级(OR=1.552, 95%CI 1.142-2.108[流行],OR=1.503, 95%CI 0.844-2.676[事件])。在汇总的数据中,主要事件(n=102)在服用达格列净的患者中更为常见(频率估计RR=1.519, 95%CI 1.239-1.861;Bayes RR=1.380, 95%CrI 0.981 ~ 1.944)。服用达格列净的患者也更有可能在6个月时出现更差的NYHA分级(OR=1.540, 95%CI 1.208-1.962;Bayes OR=1.425, 95%CrI 1.098-1.781)。结论:在最初6个月的治疗中,服用达格列净的CHF患者的预后比服用恩格列净的患者差。数据强调在这种情况下需要对两种治疗进行直接随机比较。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Croatian Medical Journal
Croatian Medical Journal 医学-医学:内科
CiteScore
3.00
自引率
5.30%
发文量
105
审稿时长
6-12 weeks
期刊介绍: Croatian Medical Journal (CMJ) is an international peer reviewed journal open to scientists from all fields of biomedicine and health related research. Although CMJ welcomes all contributions that increase and expand on medical knowledge, the two areas are of the special interest: topics globally relevant for biomedicine and health and medicine in developing and emerging countries.
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