DAPA-HF Trial Results — EECC MCQ

Correct answer: B — DAPA-HF demonstrated that dapagliflozin 10 mg reduced the composite of worsening HF or cardiovascular death by 26% in HFrEF (LVEF ≤40%), regardless of diabetes status — together with DELIVER (HFmrEF/HFpEF), it established SGLT2i benefit across all EF ranges

DAPA-HF (2019) was the first SGLT2i trial in HFrEF: 4,744 patients with LVEF ≤40% (NYHA II-IV, elevated NT-proBNP) randomised to dapagliflozin 10 mg vs placebo on top of GDMT. Results: 26% relative risk reduction in the composite of CV death or worsening HF, driven by reductions in HF hospitalisation and CV death individually. Critically, ~58% of patients did NOT have diabetes, and the benefit was identical regardless of diabetes status. DELIVER (2022) then extended the benefit to LVEF >40% (HFmrEF/HFpEF). Together, DAPA-HF and DELIVER (dapagliflozin) + EMPEROR-Reduced and EMPEROR-Preserved (empagliflozin) established SGLT2 inhibitors as the fourth pillar of HF therapy across the entire EF spectrum — the only drug class with proven benefit in both HFrEF and HFpEF.

Reference: ESC (2023): HF Guidelines; DAPA-HF Trial