Impact of Dapagliflozin on Mortality in Patients With Heart Failure and Reduced Ejection Fraction: A Meta-analysis.

The DAPA-HF trial1 demonstrated that dapagliflozin reduced the risk of worsening heart failure and death in patients with heart failure and reduced ejection fraction (HFrEF). In the EMPEROR-Reduced trial,2 empagliflozin also reduced the composite primary endpoint but failed to show any significant reduction of cardiac death or all-cause death. This may be explained by the fact that EMPEROR-Reduced was underpowered regarding cardiac death or all-cause death. A meta-analysis3 of these 2 trials revealed that the estimated treatment effect of cardiac death and all-cause death was modestly significant. In view of this, it would be necessary to revisit the mortality benefits of dapagliflozin, as DAPA-HF was not powered for the mortality endpoints either. Here, we undertook a meta-analysis of DAPAHF and the HFrEF subgroup of DECLARE-TIMI 584 to evaluate the mortality benefits of dapagliflozin in HFrEF patients.