# DELIVER: dapagliflozine effectief bij HFmrEF en HFpEF

*geplaatst 2022-09-22 · Hartfalen · The New England journal of medicine · doi 10.1056/NEJMoa2206286 · https://hartvaat.nl/2022/09/22/deliver-dapagliflozine-effectief-bij-hfmref-en-hfpef/*

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.

## English: Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.

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.

## Abstract (original, from the publication)

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.).

Auteurs: 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

---
Bron: The New England journal of medicine, https://doi.org/10.1056/NEJMoa2206286. Bijgewerkt 2026-07-03T18:38:55Z. 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.