Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure
Abstract Aims Dapagliflozin (DAPA), a sodium‐glucose co‐transporter 2 inhibitor, has been shown to reduce cardiovascular mortality among patients with chronic heart failure. We aimed to evaluate the impact on a worsening renal function (WRF) by adding DAPA as compared to standard decongestive therap...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15212 |
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| _version_ | 1849722394625703936 |
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| author | Shodai Kawanami Yasuyuki Egami Masaru Abe Mizuki Osuga Hiroaki Nohara Kohei Ukita Akito Kawamura Koji Yasumoto Naotaka Okamoto Yasuharu Matsunaga‐Lee Masamichi Yano Masami Nishino |
| author_facet | Shodai Kawanami Yasuyuki Egami Masaru Abe Mizuki Osuga Hiroaki Nohara Kohei Ukita Akito Kawamura Koji Yasumoto Naotaka Okamoto Yasuharu Matsunaga‐Lee Masamichi Yano Masami Nishino |
| author_sort | Shodai Kawanami |
| collection | DOAJ |
| description | Abstract Aims Dapagliflozin (DAPA), a sodium‐glucose co‐transporter 2 inhibitor, has been shown to reduce cardiovascular mortality among patients with chronic heart failure. We aimed to evaluate the impact on a worsening renal function (WRF) by adding DAPA as compared to standard decongestive therapy with loop diuretics alone. Methods and results We enrolled 114 consecutive acute decompensated heart failure (ADHF) patients with a left ventricular ejection fraction (LVEF) of less than 50%. The patients were prospectively randomized to be assigned either to DAPA group who received DAPA at a dose of 10 mg once daily within 24 h after admission or conventional therapy group (CON group) who received loop diuretics alone. All patients were adjusted by increasing or decreasing the loop diuretic by 10 mg to maintain a 1–2 mL/kg/h urine output. The primary endpoint was the incidence of WRF, which was defined as an increase in the serum creatinine of ≥0.3 mg/dL from baseline. The median age of the patients was 77 [interquartile range (IQR): 64, 85] years, 35% were female and the median LVEF was 33 [IQR: 28, 38] %. There was no significant difference in the incidence of WRF between the two groups (16.1%, n = 9 vs. 12.1%, n = 7, P value = 0.54). The total dose of loop diuretics through day 7 was lower in the DAPA group than CON group (184 ± 79.5 mg vs. 214 ± 66.5 mg, P value = 0.03). Conclusions This randomized prospective trial revealed the addition of DAPA within 24 h after admission reduced the diuretic dose without WRF. |
| format | Article |
| id | doaj-art-a37f2de1ecd341f7b6487587fa982a31 |
| institution | DOAJ |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-a37f2de1ecd341f7b6487587fa982a312025-08-20T03:11:21ZengWileyESC Heart Failure2055-58222025-06-011232023203310.1002/ehf2.15212Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failureShodai Kawanami0Yasuyuki Egami1Masaru Abe2Mizuki Osuga3Hiroaki Nohara4Kohei Ukita5Akito Kawamura6Koji Yasumoto7Naotaka Okamoto8Yasuharu Matsunaga‐Lee9Masamichi Yano10Masami Nishino11Division of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanAbstract Aims Dapagliflozin (DAPA), a sodium‐glucose co‐transporter 2 inhibitor, has been shown to reduce cardiovascular mortality among patients with chronic heart failure. We aimed to evaluate the impact on a worsening renal function (WRF) by adding DAPA as compared to standard decongestive therapy with loop diuretics alone. Methods and results We enrolled 114 consecutive acute decompensated heart failure (ADHF) patients with a left ventricular ejection fraction (LVEF) of less than 50%. The patients were prospectively randomized to be assigned either to DAPA group who received DAPA at a dose of 10 mg once daily within 24 h after admission or conventional therapy group (CON group) who received loop diuretics alone. All patients were adjusted by increasing or decreasing the loop diuretic by 10 mg to maintain a 1–2 mL/kg/h urine output. The primary endpoint was the incidence of WRF, which was defined as an increase in the serum creatinine of ≥0.3 mg/dL from baseline. The median age of the patients was 77 [interquartile range (IQR): 64, 85] years, 35% were female and the median LVEF was 33 [IQR: 28, 38] %. There was no significant difference in the incidence of WRF between the two groups (16.1%, n = 9 vs. 12.1%, n = 7, P value = 0.54). The total dose of loop diuretics through day 7 was lower in the DAPA group than CON group (184 ± 79.5 mg vs. 214 ± 66.5 mg, P value = 0.03). Conclusions This randomized prospective trial revealed the addition of DAPA within 24 h after admission reduced the diuretic dose without WRF.https://doi.org/10.1002/ehf2.15212acute decompensated heart failuredapagliflozindiureticsworsening renal function |
| spellingShingle | Shodai Kawanami Yasuyuki Egami Masaru Abe Mizuki Osuga Hiroaki Nohara Kohei Ukita Akito Kawamura Koji Yasumoto Naotaka Okamoto Yasuharu Matsunaga‐Lee Masamichi Yano Masami Nishino Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure ESC Heart Failure acute decompensated heart failure dapagliflozin diuretics worsening renal function |
| title | Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure |
| title_full | Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure |
| title_fullStr | Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure |
| title_full_unstemmed | Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure |
| title_short | Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure |
| title_sort | randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure |
| topic | acute decompensated heart failure dapagliflozin diuretics worsening renal function |
| url | https://doi.org/10.1002/ehf2.15212 |
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