{"id":"5bbd94bd3de9","type":"article","url":"https://hartvaat.nl/2022/09/22/deliver-dapagliflozine-effectief-bij-hfmref-en-hfpef/","title":"DELIVER: dapagliflozine effectief bij HFmrEF en HFpEF","title_en":"Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","canagliflozine","dapa-hf","dapagliflozine","empagliflozine","emperor-trials","hfmref","hfpef","hfref","step-hfpef","summit-trial"],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa2206286","source_url":"https://doi.org/10.1056/NEJMoa2206286","authors":["Scott D Solomon","John J V McMurray","Brian Claggett","Rudolf A de Boer","David DeMets","Adrian F Hernandez","Silvio E Inzucchi","Mikhail N Kosiborod","Carolyn S P Lam","Felipe Martinez","Sanjiv J Shah","Akshay S Desai","Pardeep S Jhund","Jan Belohlavek","Chern-En Chiang","C Jan Willem Borleffs","Josep Comin-Colet","Dan Dobreanu","Jaroslaw Drozdz","James C Fang","Marco Antonio Alcocer-Gamba","Waleed Al Habeeb","Yaling Han","Jose Walter Cabrera Honorio","Stefan P Janssens","Tzvetana Katova","Masafumi Kitakaze","Béla Merkely","Eileen O'Meara","Jose Francisco Kerr Saraiva","Sergey N Tereshchenko","Jorge Thierer","Muthiah Vaduganathan","Orly Vardeny","Subodh Verma","Vinh Nguyen Pham","Ulrica Wilderäng","Natalia Zaozerska","Erasmus Bachus","Daniel Lindholm","Magnus Petersson","Anna Maria Langkilde"],"significance":10,"published":"2022-09-22","source_date":"2022-09-22","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfmref-hartfalen-met-matig-verminderde-ejectie/","https://hartvaat.nl/kennis/hartfalen/sglt2-remmers-bij-hartfalen/"],"congress":"","summary_en":"The DELIVER trial demonstrated that dapagliflozin significantly reduced the composite of worsening heart failure or cardiovascular death in patients with heart failure and an ejection fraction above 40%, regardless of diabetes status. Together with EMPEROR-Preserved, this confirmed the benefit of SGLT2 inhibitors across the full ejection fraction spectrum.","created":"2026-07-03T10:29:56Z","updated":"2026-07-03T18:38:55Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De DELIVER-trial in de NEJM toonde dat dapagliflozine het risico op hartfalenverslechtering en CV-sterfte significant verminderde bij patiënten met HF en EF >40%. Dit landmark-resultaat bevestigt dat SGLT2-remmers effectief zijn over het volledige ejectiefractie-spectrum en verandert de hartfalenbehandeling fundamenteel.","abstract_original":"BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure and cardiovascular death among patients with chronic heart failure and a left ventricular ejection fraction of 40% or less. Whether SGLT2 inhibitors are effective in patients with a higher left ventricular ejection fraction remains less certain. METHODS: We randomly assigned 6263 patients with heart failure and a left ventricular ejection fraction of more than 40% to receive dapagliflozin (at a dose of 10 mg once daily) or matching placebo, in addition to usual therapy. The primary outcome was a composite of worsening heart failure (which was defined as either an unplanned hospitalization for heart failure or an urgent visit for heart failure) or cardiovascular death, as assessed in a time-to-event analysis. RESULTS: Over a median of 2.3 years, the primary outcome occurred in 512 of 3131 patients (16.4%) in the dapagliflozin group and in 610 of 3132 patients (19.5%) in the placebo group (hazard ratio, 0.82; 95% confidence interval [CI], 0.73 to 0.92; P<0.001). Worsening heart failure occurred in 368 patients (11.8%) in the dapagliflozin group and in 455 patients (14.5%) in the placebo group (hazard ratio, 0.79; 95% CI, 0.69 to 0.91); cardiovascular death occurred in 231 patients (7.4%) and 261 patients (8.3%), respectively (hazard ratio, 0.88; 95% CI, 0.74 to 1.05). Total events and symptom burden were lower in the dapagliflozin group than in the placebo group. Results were similar among patients with a left ventricular ejection fraction of 60% or more and those with a left ventricular ejection fraction of less than 60%, and results were similar in prespecified subgroups, including patients with or without diabetes. The incidence of adverse events was similar in the two groups. CONCLUSIONS: Dapagliflozin reduced the combined risk of worsening heart failure or cardiovascular death among patients with heart failure and a mildly reduced or preserved ejection fraction. (Funded by AstraZeneca; DELIVER ClinicalTrials.gov number, NCT03619213.)."}