Dapagliflozin Reduces Heart Failure Worsening in Elderly Patients with Severe Aortic Stenosis
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on May 9th, 2025
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Many clinical guidelines in both the United States and Europe recommend the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors for patients with heart failure, regardless of diabetes status. However, individuals with severe valvular heart disease requiring transcatheter aortic-valve implantation have largely been excluded from these studies. To address this gap, a study funded by the Carlos III Health Institute in Spain was conducted to evaluate the use of SGLT2 inhibitors in patients with severe aortic stenosis.
The clinical trial enrolled 1222 participants diagnosed with aortic stenosis who had a history of heart failure episodes. The median age of the cohort was 82.4 years, with a high prevalence of comorbidities such as hypertension (85%), type 2 diabetes (44%), and atrial fibrillation (43%). Participants continued to receive standard care and were randomly assigned to receive either a placebo or 10 mg of dapagliflozin once daily. The cardiovascular benefits of dapagliflozin are believed to stem in part from its ability to lower blood pressure.
After 12 months, patients treated with dapagliflozin showed a significantly lower risk of heart failure progression and hospitalization due to heart failure compared to the placebo group. However, dapagliflozin did not reduce mortality from cardiovascular causes. Subgroup analyses indicated that the treatment was particularly effective among patients over 80 years old, those with diabetes, hypertension, atrial fibrillation, and those with a left ventricular ejection fraction greater than 40%. Although a higher incidence of genital infections was reported among patients receiving dapagliflozin, the treatment was otherwise well tolerated and safe for elderly individuals with severe aortic stenosis.
The clinical trial enrolled 1222 participants diagnosed with aortic stenosis who had a history of heart failure episodes. The median age of the cohort was 82.4 years, with a high prevalence of comorbidities such as hypertension (85%), type 2 diabetes (44%), and atrial fibrillation (43%). Participants continued to receive standard care and were randomly assigned to receive either a placebo or 10 mg of dapagliflozin once daily. The cardiovascular benefits of dapagliflozin are believed to stem in part from its ability to lower blood pressure.
After 12 months, patients treated with dapagliflozin showed a significantly lower risk of heart failure progression and hospitalization due to heart failure compared to the placebo group. However, dapagliflozin did not reduce mortality from cardiovascular causes. Subgroup analyses indicated that the treatment was particularly effective among patients over 80 years old, those with diabetes, hypertension, atrial fibrillation, and those with a left ventricular ejection fraction greater than 40%. Although a higher incidence of genital infections was reported among patients receiving dapagliflozin, the treatment was otherwise well tolerated and safe for elderly individuals with severe aortic stenosis.